Vol. V - MSK, Rheum, Derm Flashcards
Trapezius is innervated by
accessory nerve
Cell mediating dermatomyositis
CD4 T cells –> perimysial inflammation
Tibial nerve roots
L4-S3
Most common causes of septic arthritis
S.aureus, Strep, N. gonorrheae
location of osteosarcoma
metaphysis of long bones
femoral nerve roots
L2-L4
Obdurator nerve innervates
sensory - medial thigh
motor - adductors, obdurator, pectineus
iliohypogastric nerve innervates
sensory - suprapubic region
motor - transversus abdominus and internal oblique
axillary nerve roots
C5-C6
Acetaminophen mechanism
reversible inhibits COX, mostly in CNS (not anti inflammatory)
Abnormal labs in osteomalacia/rickets
decreased Ca, decreased PO4, increased ALP, increased PTH, vitamin D deficient
Abnormal labs in osteitis fibrosa cystica (secondary hyper pth)
decreased Ca, increased PO4, increased ALP, increased PTH
IT band syndrome
Overuse injury of lateral knee (e.g. in runners). Pain is 2/2 friction of the IT band on the lateral femoral epicondyle.
serratus anterior is innervated by
long thoracic nerve
Common (fibular) peroneal nerve roots
L4-S2
genitofemoral nerve innervates
sensory - scrotum/labia and medial thigh
motor - cremaster
RA involves
PIP, MCP, wrist
Zileuton blocks
5-Lipoxygenase (no Leukotrienes)
Type I muscle fiber properties
Slow, Red, uses Ox Phos, associated with endurance training
Peroneal/fibular nerve injury
foot drop
Abnormal labs in osteitis fibrosa cystica (primary hyper pth)
increased Ca, decreased PO4, increased ALP, increased PTH
contents of carpal tunnel
FDS tendons, FDP tendons, FPL tendon, median nerve
Limb compartment syndrome
increased pressure within fascial compartment of a limb –> venous outflow obstruction and arterial collapse –> anoxia and necrosis.
lunate dislocation can cause
median nerve impingement –> carpal tunnel
Osteoarthritis presentation
improves with rest, asymmetric involvement, bowlegged
Leflunomide mechanism
Reversibly inhibits dihydroorate dehydrogenase –> blocks pyrimidine synthesis –> suppreses T cell proliferation
Median nerve roots
C5-T1
Prevention of pseudogout
colchicine
Guyon canal syndrome is caused by
compression of the ulnar nerve at the risk (e.g. cyclists)
hip abductors
gluteus medius, gluteus minimus
Sciatic nerve roots
L4-S3
tumor associated with vinyl chloride and arsenic
hepatic angiosarcoma
Effect of PGF2alpha
increased uterine tone
Effect of PGE1
decreased vascular tone
Treatment for Paget’s disease of the bone (aka Osteitis Deformans)
bisphosphonates
Superior gluteal nerve roots
L4-S1
Abnormal labs in Paget disease
increased ALP
RA presentation
morning stiffness lasting > 1 hr, improves with use, symmetric involvement, systemic manifestations
synthetic PGE2
Dinoprostone
internal rotation of the hip
gluteus medius, gluteus minumus, tensor fascia lata
NSAID mechanism
reversible COX inhibition blocking prostaglandins
Treatment for Raynaud’s
Ca channel blockers
tibial nerve injury presentation
can’t stand on tiptoes (inversion and plantarflexion is lost)
Treatment for myasthenia gravis
AChE Inhibitor (pyridostigmine)
Cell mediating polymyositis
CD8 T cells –> endomysial inflammation
synthetic PGI2
Epoprostenol
iliohypogastric nerve roots
T12-L1
claw hand on digit extension
ulnar nerve injury
osteoarthritis involves
DIP and 1st CMC
Genitofemoral nerve roots
L1-L2
Inferior gluteal nerve roots
L5-S2
albinism pathophysiology
normal melanocytes with reduced melanin production due to decreased tyrosinase activity or defective tyrosine transport
Effect of PGE2
increased uterine tone
Scalded skin syndrome is caused by
Staph exotoxin destroying attachments in the stratum granulosum
Lat fem Q nerve innervates
sensory - anterior and lateral thigh
Type II muscle fiber properties
Fast, white, Anaerobic glycolysis, associated with strength and sprinting
RA serology
Anti-CCP is most specific, also se RF (anti IgG FC IgM Abs)
offending organism in an abscess is usually
S. Aureus
Abnormal labs in osteoporosis
decreased bone mass
crystals in calcium pyrophosphate deposition disease
aka pseuodgout - crystals are rhomboid and weakly + bifringent
De Quervain tenosynovitis is caused by
Noninflammatory thickening of apl and epb tendons –> pain and tenderness at radial styloid
Presentation of radial head subluxation
(aka nursemaids elbow) injured arm is slightly flexed and pronated.
Diffuse scleroderma serology
anti-scl-70 (DNA topoisomerase) and anti-RNA-pol-III
Radial nerve roots
C5-T1
wrist drop
radial nerve injuriy
Classic gout presentation
painful MTP joint of big toe
Mixed connective tissue disorder serology
anti-U1 RNP
Deltoid is innervated by
axillary nerve
Musculocutaneous roots
C5-C7
hip flexors
iliopsoas, rectus femorus, tensor fascia lata, pectineus, sartorius
location of Ewing Sarcoma
diaphysis of long bones
Probenecid mechanism
inhibits reabsorption of uric acid in the PCT
Muscles int he rotator cuff
Supraspinatis, infraspinatus, teres minor, subscapularis
Lat fem Q nerve roots
L2-L3
Trandeleburg sign
superior gluteal nerve injury (med and min) contralateral to drop
Femoral nerve innervates
sensory - anterior thigh and medial leg
motor - quadriceps, iliacus, pectineus, sartorius
Abnormal labs in osteopetrosis
may see decreased serum Ca on severe cases, dense, brittle bones
SLE serology
ANA, anti-dsDNA, anti-Sm, antiphospholipid, SS-A, SS-B
external rotation of the hip
iliopsoas, gluteus maximus, piriformis, obdurator
superficial laceration of the hand can damage/cause
recurrent branch of the median nerve –> ape hand and loss of thenar muscles
hip extensors
gluteus maximus, semitendinosus, semimembranosus
Teripartide mechanism
PTH analog –> pulsatile dose increases osteoblast activity
Greenstick fracture
incomplete fracture from bending stress, bone fails on tension side, pediatric
synthetic PGF2alpha
Carboprost
vitiligo pathophysiology
destruction of melanocytes
most commonly fractures carpal bone
scaphoid (from FOOSH)
Sciactic nerver innervates
motor - hamstrings, adductor magnus
Obdurator nerve roots
L2-L4
Effect of LTC/D/E4
increased bronchial tone
Cause of achondroplasia
AD mutation causing constitutive activation of FGFR3
Aspirin mechanism
irreversibly inhibits COX by acetylation
hip adductors
adductor magnus, adductor longus, adductor brevis
synthetic PGE1
Alprostadil
Glucocorticoids block
phospholipase A2 and NF-kappaB
Abnormal labs in Hypervitamin D
increased Ca, increased PO4, decreased PTH
Effect of thromboxane A2
increased platelet aggregation and vascular tone
Drugs for chronic gout prevention
xanthine oxidase inhibitors: allopurinol, febuxostat
Torus (buckle) fracture
axial force –> cortex buckles on compression side, pediatric
Defect in Ewing Sarcoma
t(11;22) fusion protein
Sjogren syndrome serology
ANA, SS-A, SS-B, RF
inferior gluteal nerve innervates
gluteus maximus
anterior knee pain syndromes
Osgood-Schlatter disease (proximal tibial tubercle) and Patellofemoral (overuse made worse by sitting and weight bearing on a flexed knee)
Pudendal nerve roots
S2-S4
Nerve involved in carpal tunnel
median nerve
allele associated with seronegative spondyloarthritis
HLA-B27
benediction hand / ape hand
median nerve injury (can’t flex or feel lateral three digits / thenar eminence)
Virus that mediates hairy leukoplakia
EBV
Bisphosphonate mechanism
bind hydroxyapatite in bone, inhibiting osteoclasts
Effect of LTB4
neutrophil chemotaxis
Effect of PGI2
aka prostacyclin, causes decreased platelet aggregation and vascular tone
Celecoxib mechanism
selective COX-2 inhibition