Wed Wk 3 MSK 3 Flashcards

1
Q

__ is protein toxin of C tetani
travels via __ axonal transport to CNS
inhibits release of G/G inhib neurotransmitters, resulting in sustained muscle contration
prevent w tetanus __ vaccine
produces antibodes that neutralize bacterial ___
this formed used for all protein __ diseases

Ab that promote complement formation is useful against __

DMD causes __ difficulties initially
then presents w __ sign and calf __
assymetric weakening of paraspinal muscles leads to K__

A
Tetanospasmin, retrograde
Glycine, Gaba
toxoid
products
toxin

bacteria

ambulation
Gower, pseudohypertrophy
kyphoscoliosis

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2
Q

in HPGRT, mutation results in inc prodxn of __ w feed forward activation
constant degredation leads to hyper__

Colchicine also dec __ phosphorylation to dec PMN activation

Pseudogout more likely affects __ than gout
crystals are __ birefringent and __ shaped

A

purines
uricemia

tyrosine

knee
positive, rhomboid

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3
Q

pt w menopausal sx likely has O__
do not tx w EE as it inc risk of __/__ cancer

use selective estrogen receptor modulators R/T
have both __/__ properties in tissue specific manner
Raloxifene has estrogen __ in bone, antagonist in __/__ thus no inc risk of cacner

Tamoxifen has antagonist effects on __ useful for ER+ BC
has agonist affect on __/__, thus does inc risk of uterus cancer

A

osteoporosis
breast/endometrial

raloxifene, tamoxifen
antag, agonist
agonist, breast/uterus

breast
bone/endometrium

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4
Q

nonmodifiable RF for osteoporosis include A__, C/A ethnicity, FH of __
modifiable- low __ and physical activity, poor __/__, inc alcohol/tobacco, premature __ and GC use

GC antiinflammatory effect by inhibiting __

elderly pt w inc ALP has __ dz of bone
excessive __ and nfKB activation
1st phase is __ phase
appear __ w great amnt of nuclei

2nd phase is __
rapid inc in __ w persistent oc activity
interspersed areas of lamellar and __ bone

Phase 3 is __ dominant
dense, mosaic pattern w prominent central __

A

age, caucasian, asian, osteo
body weight, Ca/VD, menopause

phospholipase A2

Paget
RANKL
oc
large

mixed
OB
woven

OB
lines

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5
Q

tissue inflammation in RA causes A__ residues to be converted to citrulline via cintrullination
alters __ of proteins, becoming antigens for an immune response

carpal tunnel is defined by carpal bones on dorsum and __ ligament (FR) on volar surface
contains FDP, FDS, median nerve and F__
cut the __ for relief

ischemic optic neuropathy in GCA due to __ artery occlusion

XO and __ catalyze azathioprine metabolic pathways
if inhibited, 6thioguanine is incorporated into __ leading to many problems

A

arginine
shape

transverse carpal
flexor pollicus longus
FR

ophthalmic

TPMT
DNA

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6
Q

PTH stimulates __ to release RANKL/MCSF thus activating differentiation of OC
also dec release of __ which blocks activation of OC

IGF promotes __ synthesis

T3 inc bone turnover by upregulating __ activity

COX2 is upregulated by __/__ in inflammation

pt older than 20 w profuse acne may be using anabolic steroids like M__

Acne is due to follicular epidermal __, excessive __ prodxn, inflammation, and P acnes

androgens stimulate __ and FE hyperlasia

can also be seen w __ inhibs and lithium

A

OB
OPG

OB

OC

IL1/TNF

methyltestosterone

hyperplasia, sebum

sebum

EGFR

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7
Q

at membrane potential, high __ inside cell
high __ and __ outside

Hip flexion due to I, R, Tensor fascia lata
Iliopsoas made of Psoas m/m and iliacus

Extension via gluteus __, semimemrbanosus/tendinosus, BF __

Abduction due to Gluteus M/M

Adduction via Adductor B/L/M

muscles used when sitting up include external __, rectus abdoinis, and ___

A

K
Na, Cl

iliopsoas, rectus ab
major, minor

maximus
biceps femoris long head

medius, minimus

brevis, longus, magnus

oblique, iliopsoas

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8
Q

superficial peroneal nerve helps in E__ of foot
sensation to __ of foot

deep peroneal nerve provides sensation bw __ and __ toes

loss of sensation over medial leg is due to damage to the __ nerve

days to weeks after Lyme dz, pt experiences __ sx and erythema chronicum migrans

wks later, may get __ palsy and cardiac involvement like AV __

years later, if pt receives __ may get assymetric monoarthrtitis and enceph
tx w D or C

A

eversion
dorsum

1, 2

saphenous

flu like

facial
nodal block

antibiotics
doxycycline, ceftriaxone

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9
Q

__ is thoracolumbar muscle which aids in extension, adduction, and internal rotation of humerus
innervated by __ nerve

T__ is large upper back muscle commonly injured in MVA

pt w asthma, rhinosinusitis and eosinophilia has \_\_
can involve K/G/C systems
may have \_\_ multiplex due to vasculitis
can have skin \_\_ and pulm infiltrates
pANCA against \_\_

anti RNA poly 3 is seen in __ dz

A

lat dorsi
thoracodorsal

trapezius

EGP
kidney, GI, cardio
mononeuritis
nodules
MPO

systemic sclerosis

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10
Q

pt w red rash on face w pallor and fever, maybe over arms/legs/trunk has __ dz
acute __ is manifestation in adults, usually in PIP, MCP, knee and ankle
signifies an immune response w formation of __
Parvo athritis mimics __ but self resolves

MMP function in degredation of __ and ECM proteins
encourages myofibroblast __ at wound edges and scar tissue remodeling
these myofibroblasts initiate wound __ by secondary intention

Ulceration develops w inadequate __ of wound
think LE wounds w ___ dz

IGF1 prevents collagen degradation by inhibiting __ 13

A

erythema infectiosum
arthropathy
IC
RA

collagen
accumulation
contracture

vascularization
PVD

MMP

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11
Q

__ are cells w single nucleus arising from mesenchymal stem cells in periosteum/bone marrow
OC originate from __ and form w fusion into a multinucleated __ cell

Elderly pt w bone pain and hearing loss, suspect __

Median/Radial nerve and __ artery found at supracondylar region of humerus
median nerve and brachial artery are found __
radial nerve is found __

A

OB
monocytes
mature

PDB

brachial
medial
lateral

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12
Q

young pt w assymetric oligoarthritis, enthesitis, dactylitis has __ arthritis
may see C and uveitis
urethritis and Keratoderma __ or oral ulcers

caused by __ involing bacterial antigens but w out disseminated infection
thus, synovial fluid is __

Lunate is more __ of bones that articulate w radius
scaphoid is more __

__ contacts first digit
Hamate is found on __ closest to lunate

A

reactive
conjunctivitis
blenorrhagicum

immune complexes
sterile

medial
lateral

trapezium

outside

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13
Q

D__ is sustained involuntary muscle contraction
cervical dystonia called spasmodic T__ is most common
due to impaired fxn of B__

second most common is B__ w closure of eyelids
writers __ affects the hand

M__ is brief, sudden contraction

Anatomic snuffbox formed by tendons of EPL and APL/EPB
scaphoid and __ forms floor
dorsal __ branch of radial artery supplies blood, and is easily interrupted by fracture
high risk for __ and nonunion

A

dystonia
torticollis
basal ganglia

blepharospasm
cramp

myoclonus

extensor pollicus longus, abductor pollicus longus, extensor pollicus brevis
trapezium
scaphoid
Avascular necrosis

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14
Q

RF for rickets include exclusive __ and inadequate sun exposure
inc skin _ and maternal VD def

sx include soft skull C__ and delayed fontanel __
Frontal __
hypertrophy of __ joints
widened/thickening of E__ and genu varum

pt w spinal stenosis has hypertrophy of ligamentum __
found on __ aspect of SC
due to __ arthritis, IV disc protrudes and loses height
facet joints get O__ w mechanical compression of nerves

ALL covers __ aspect of vertebral bodies
prevents spinal __

A

breastfeeding
pigmentation

craiotobes, closing
bossing
costochondral
epiphyseal plate

flavum
posterior
degenerative
osteophytes

anterior
extension

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15
Q

pt w high fever and extreme pain in bone has __
usually affects __ of long bones due to slow flowing vasculature
heme dissemination seeds bony __ and inc intramedullary pressure
dec blood flow contributes to bone ___
w out tx, get chronic __ osteomyelitis and necrosis
becomes covered in necrotic I__ w formation of sinus channels
can affect P__
tx w __ and debridement of __ bone

primary psoas abscess presents w F, ab pain and __
located adjacent to __
rf include H, IV __ and diabetes

A
osteomyelitis
metaphysis
space
ischemia
involucrum, periosteum
ab, necrotic

fever, bleeding
spine

HIV, drug use

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16
Q

deltoid/supraspinatus abduct arm to __ degrees
beyond that, T/S take over

RA caused by __ T cells releasing cytokines for inflamm synovitis

B cells then produce ___

damage to tibial nerve causes weak __ flexion due to impaired Gastroc, soleus, plantaris
also weak foot __ and toe __

injury at the tarsal tunnel would only produce sensory loss of __ foot muscles

A

90
trapezius, serratus

CD4

antibodies

plantar
inversion, flexion

intrinsic

17
Q

OSD is overuse of secondary __ center of tibial tubercle
seen in adolescent __ w growth spurt
pain and swelling at __ over patellar ligament
seen w repetitive __ contraction
Quad muscles include R__ femoris, Vastus M/L/I

can heal w __ which is prominent

pes anserine bursitis is located over __ medial aspect of knee

A
ossification
athelete
tibial tuberosity
quadriceps
rectus
medialis, lateralis, intermedius

callous

anterior

18
Q

at the tibial plateua, the ACL is __ and PCL is posterior

sx of psoas abscess include F, back/flank __, inguinal __ and difficulty walking
pain occurs when psoas is __ such as hip extension
pt usually prefers hip flexion and lumbar __

A

anterior

pain, mass
extended
lordosis

19
Q

Thoracic outlet is space above __ rib and behind clavicle bordered by cervical __ and sternum
compression of __ leads to upper extremity numbness, tingling, weakness

compression of subclavian __ leads to UE swelling
compression of subclavian __ leads to extertional pain

TOS occurs in __ triangle, as brachial plexus and __ artery run through
formed by __/__ scalenes
can be damaged w extra __ or scalene muscle abnormality or injury

A

1st
vertebrae
BP

vein
artery

scalene
subclavian
anterior/medial
rib

20
Q

pt w paroxysmal supraventricular tachycardia can be tx w __ massage or valsalva to inc PNS tone

Valsalva performed by __ muscles

gluteus maximus is most important __ of thigh at hip

A

carotid sinus

rectus

extensor