Sports Injuries and Rheumatology Flashcards
colchicine used to treat _____
inhibits ____________, which disrupts chemotaxis, phagocytosis, degranulation, and also reduces formation of LTB4
gout
microtubular polymerization
young boy with fever and bone pain =
primarily affects the _______ of _____ bones
hematogenous osteomyelitis
metaphysis
long
normal infant at birth, progresses to lethargy, poor feeding, constipation, hypotonia, puffy face, umbilical hernia, protruding tongue, large anterior fontanelle, irreversible intellectual disability risk =
common cause
why delayed
congenital hypothyroidism
iodine deficiency
maternal T4 still active
osteocytes send signals and exchange nutrients and waste products within neighboring lamellae via _____
gap junctions
_________ is a benign childhood disorder marked by severe arthritis in adult life. This _____ disorder is caused by deficiency of ___________. Accumulated homogentisic acid causes pigment deposits in connective tissue through the body, notable blue black deposits in the sclerae and ear cartilage. Urine in these patients turns _____ when exposed to air
Alkaptonuria
AR
homogentistic acid dioxygenase
black
couple, similar pruritic papulopustural rash, back recently from vacation, most likely =
G negative rod, oxidase positive, produces green pigment, almost always culprit
bug also implicated in
hot tub folliculitis
P aeruginosa
burn victims
the _____ receptor initiate the extrinsic pathway of apoptosis. Mutations here or at the ____ligand can prevent apoptosis of autoreactive lymphocytes, thereby increasing the risk of AI disorders such as SLE
Fas
Fas
C tetani produces the ______ tetanospasmin that blocks the release of inhibitory NTs from inhibitory motor interneurons in the CNS. Tetanus is prevented by immunization with ______ that triggers the production of antitoxin antibodies.
exotoxin
toxoid
3 year old, pushes up from squat, enlarged calves =
due to a mutation affecting _________
inheritance =
truncated version of dystrophin =
Duchenne muscular dystrophy; Gower’s sign
dystrophin, sarcolemma cytoskeleton linker protein
X linked p21
Becker muscular dystrophy
sitting up from supine involves external abd. obliques, rectus abdominis, and
Iliopsoas
aortic dissection, mitral valve prolapse, spontaneous pneumothorax from apical blebs, ectopia lentis, joint hypermobility, marfan body type =
protein affected is ________ and is an extracellular glycoprotein that acts as a scaffold for _____
If affected protein was collagen =
Marfan syndrome
fibrillin-1
elastin
Ehlers-Danlos
headaches, visual and muscular symptoms, enlarged temporal artery, elevated ESR =
associated =
production of ______ correlates closely with severity of disease. Treatment with monoclonal antibody _____ is effective
Giant Cell Arteritis (temporal)
polymyalgia rheumatica
IL6
tocilizumab
Substance X causes an increase in serum calcium and URINE phosphate =
receptors found on ________
causes them increase production of ______ and MCSF
also decreases the release of _______, which will increase bone turnover
calcitonin effect is ______ of this
PTH
osteoblasts
RANK-L
OPG
opposite
Achondroplasia is due to a point mutation in ______ which causes exaggerated inhibition of ______
FGFR3
endochondral ossification
cafe-au-lait spots, precocious puberty, hyperthyroidis, mutliple osteolytic appearing lesion of hip and pelvis (fibrous dysplasia) =
Gene =
causes
McCune-Albright Syndrome
GNAS
Persistent activation of Gs/cAMP
during skeletal muscle contraction, calcium is released from the SR and binds _________, thereby allowing the binding of actin to myosin
Troponin C
postural skeletal muscles such as soleus and ______ contain predominantly __________ that derive ATP primarily from oxidative (aerobic) metabolism and have l myoglobin rich, glycogen poor fibers with many mitochondria
paraspinal muscles
Type I
bone mass in adulthood is determined by peak bone mass and the rate of bone loss. __________ women have higher bone density and a lower risk of fractures than other women
African American
acute joint pain, swelling, erythema, restricted ROM, fever =
best evaluated with ________ and should be sent for crystal analysis, cell count, gram stain, and culture
acute synovitis
arthrocentesis and synovial fluid analysis
recurrent skin and mucosal bacterial infections, no pus, poor wound healing, delayed umbilical cord separation, peripheral leukocytosis with neutrophilia =
due to absence of _____
inheritence
often infected with _____ or g(-) rods
Leukocyte adhesion deficiency
CD18
AR
S aureus
knee pain with repetitive or prolonged kneeling =
obesity or overuse knee pain along medial knee =
pain between distal femur and quads, caused by a direct blow or repetitive quadriceps activity like running =
prepatellar bursitis
anserine bursitis
suprapatellar bursitis
episodes of gouty arthritis with increased serum uric acid levels, prophylactic therapy is _________ such as allopurinol or febuxostat
first line therapy during attack =
XO inhibitors
NSAIDs
childhood osteomyelitis =
sickle cell osteomyelitis =
pott disease osteomyelitis
DM, impaired mobility, or recent trauma or surgery osteomyelitis -
S aureus
salmonella
TB
polymicrobial
early muscular dystrophy in distal muscle biopsy
late
true hypertrophy
fibrofatty muscle replacement
polyarthritis, morning stiffness, systemic symptoms, progressive joint pain in the hands that gets better as day goes on =
first line DMAR
can cause oral ulcers, alopecia, pancytopenia, hepatoxicity, and pulmonary fibrosis
RA
methotrexate
_________ such as alendronate and risedronate are the preferred initial treatment of osteoporosis and chemically resemble
bisphosphates
pyrophosphate
gaseous gangrene at a penetrating injury =
usually associated with late onset _______ and transient watery diarrhea with abdominal discomfort
clostridium perfringens
food poisoning
the ______ is anatomic space in teh wrist defined by the carpal bones on the dorsal aspect and the _________ (flexor retinaculum) and can compress the _____ nerve causing carpal tunnel syndrome (1st 3 digits and radial half of 4th)
carpal tunnel
transverse carpal ligament
median
first line treatment for GCA =
glucocorticoids
MG is associated with abnormalities of the _____, which, along with the _______ glands arises from the 3rd pharyngeal pouch
thymus
inferior parathyroid
________ is characterized by stiffness and fusion of axial joints and inflammation at the site on insertion of tendons into bone. Involvement of the ____ and ribs can limit __________, leading to hypoventilation, thus __________ should be monitored closely
Ankylosing spondylitis
thoracic spine
chest wall expansion
chest wall expansion
during wound healing, excessive MMP activity and myofibroblast accumulation in the wound margins can result in _______, most often in the palms, soles, anterior thorax, and at serious burn sites
contracture
inability to exten right wrist and several fingers, history of asthma, high Eosinophils, serum ANA/anti myeloperoxidase + =
mononeuritis multiplex due to
eosinophilic granulomatosis with polyangitis (CHurg Strauss)
involvment of epineural vessels
the ________ originates from the anterior surface of the transverse processes and lateral surface of the vertebral bodies at ________. IV drug users can develop _______ abscess at this muscle and it can seed the L spine
Psoas major
T12-L5
S aureus
foot is everted and dorsiflexed after injury
injury to =
sensory loss on =
tibial nerve, puncture at popliteal fossa
plantar surface of foot
_______ of the hands is characterized by osteophyte formation leading to hard bony enlargement of the ______ (heberden nodes) and __________ (Bouchard nodes) brief morning stiffness may be present and patients are usually older, compared to RA patients who have prolonged morning stiffness, proximal joint involvement, and are younger
Osteoarthritis
DIP
DIP
first line for gout attack =
if patient has PUD =
NSAID
Colchicine
abrupt onset fever, arthralgias, rash, ANA+, after TB therapy =
due to
Drug induced lupus erthematosus
slow liver acetylators
rhomboid shaped crystals, symptoms of gout but in the knee, synovial fluid analysis reveals elevated WBC with neutrophilic predominance =
crystals contain
pseudogout
calcium pyrophosphate
SLE: malar or discoid butterfly rash, gradual symtom onset, joint renal, serosal or neuronal involvement
Labs: anemia, leukopenia, thrombocytopenia
+______, +______ and +_________, increased immune complexes and ____ C3 and C4
Anti CCp+ =
Anti-mitochondrial antibodies + =
HLA B27 + =
ANA
AntidsDNA
Anti Smith
low
RA
primary biliary cirrhosis
seronegative spondyloarthropathies
bisphosphates attach to _______ binding sites on bony surfaces to inhibit __________ by mature ________
hydroxyapatite
bone resportion
osteoclasts
_____ occurs with increased frequency in patients with activating mutations involving phosphoribosyl pyrophosphate synthetase due to increased production and degradation of purines
gout
first line of therapy for gout
they inhibit COX and exert a broad anti-inflammatory effect that includes inhibition of _____
NSAIDs
neutrophils
the quadriceps muscle group is connected to the patella, which is in turn attached to the ________ by the patellar ligament. Repetitive quardriceps contraction can lead to ________ which is characterized by focal pain and swelling at this location
Tibial tuberosity
Osgood schlatter
____ is produced by Th2 cells, it facilitates growth and of cells and Th2 lymphocytes and stimulates the anti body isotype switch to IgE
IL4
________ is a virulence factor found in the peptidoglycan wall of S aureus that binds the Fc portion of IgG, leading to impaired complement activation, opsonization, and phagocytosis
man with pain swelling erythemia in leg after suffering minor cut
Protein A
cellulitis
polycythemia vera plus episodic knee pain, redness, swelling, non compliant with treatments =
synovial fluid contains
due to
gout
needle shaped, (-) birefringent crystals
increased uric acid production from cell turnover
preceding genitourinary infection or enteritis, followed by arthritis
extraarticular symptoms
lab?
reactive arthritis (sterile)
conjunctivitis, urethritis
HLA-B27
older man, bone pain, elevated alkphos is either ______ or _______.
biopsy showing a _____ pattern of lamellar bone is diagnostic for ________. The initial phase of this disorder is characterized by an increase in ______ activity
the second phase is mixed _______-_______ activity
the 3rd phase is the osteosclerotic phase which is _________ and presents with the mosaic pattern and prominent _______
osteoblast metastases or Paget disease of Bone
Mosaic
PDB
Osteoclast
osteoclastic-osteoblastic
Osteoblast dominant
cement lines
subcutaneous mycosis with no relevant history
fungus =
from =
sporotrichosis
Sprothrix Schenckii
thorn prick
use of a monoclonal antibody (infliximab) or venom antitoxins followed by joint pain and pruritic skin rash with fibrinoid necrosis and neutrophil infiltration =
type of reaction
other lab
serum sickness
Type III HS
low C3/C4 due to deposition of circulating immune complexes
bone specific alkphos reflects
tartrate resistent acid phosphatase, urinary hydroxyproline, and urinary doxypyridinoline reflect
osteblastic activity
osteoclastic activity