Week 3 Review Qs Flashcards
Fracture of what part of the humerus would injure the ulnar nerve?
- Medial Epicondyle
- Surgical Neck
- Anatomical Neck
- Capitulum
- Lateral Epicondyle
A. Medial Epicondyle
Which nerve is damaged in loss of opposition of the thumb?
- Ulnar Nerve
- Radial Nerve
- Median Nerve
- Musculocutaneous Nerve
C. Median Nerve
What is injured in penetrating injury to cubital fossa?
- Ulnar Nerve
- Radial Nerve
- Median Nerve
- Musculocutaneous Nerve
C. Median Nerve
Which nerve, when damaged, will result in the loss of sensation to the medial one and a half fingers?
- Ulnar Nerve
- Radial Nerve
- Median Nerve
- Musculocutaneous Nerve
A. Ulnar Nerve
Which pair of nerves are responsible for supination of the forearm?
- Ulnar Nerve
- Radial Nerve
- Median Nerve
- Musculocutaneous Nerve
B&D
B. Radial Nerve
D. Musculocutaneous Nerve
Which nerve injury results in a wrist drop?
- Ulnar Nerve
- Radial Nerve
- Median Nerve
- Musculocutaneous Nerve
B. Radial Nerve
Which muscle is responsile for the abduction and flexion of the hand at the wrist?
Flexor carpi radialis
Which muscle is resposnible for flexion of the proximal interphalaangeal joints and metacarpophalangeal joints?
Flexor digitorum profundus
Which mesoderm gives the myotome?
Paraxial
Which of the following gives rise to the vertebra?
Sclerotome
What will result from failure of fusion of the two vertebral arches?
Spina bifida
What will result from non-ossification of one of the vertebral centers?
Which of the following muscle diseases is characterixed by muscles that are PAS positive?
A 50-year-old woman with RA since age 20 presents with heavy proteinuria. What do you expect to in the kidney biopsy?
Amyloid
What is responsible for the extended structure of proteoglycan?
Polysaccharides with charge [charged polysaccharide]
Which of the following cytokines activates T-cells in a rheumatoid joint?
IL-6
Which of the following is associated with a higher risk of RA?
HLA-DR (DR-2 and DR-3)
Which cytokine is now targeted as therapy for rheumatoid arthritis?
TNF-α
Which muscle is supplied by the median nerve?
Flexor digitorum superficialis
Which of the following, along with HLA-DR4, increases the risk of developing rheumatoid arthritis?
Smoking
Which part of the long bone undergoes primary ossification?
Diaphysis
A woman suffers from knee and wrist swelling. A specimen was taken from her joints. Which of the following strongly suggests rheumatoid arthritis?
Thickening of the synovium with a chronic inflammatory reaction
Failure of fusion of vertebral arches?
Spina bifida
Failure of one half of the vertebral centrum to ossify?
What cells are responsible for the tissue damage in rheumatoid arthritis?
- Th1
- Th2
- Plasma cells
- Natural killer cells
- Cytotoxic T cells
A) Th1 (produce cytokine soup with help of activated macrophages)
What structure contributes to development of vertebrae?
- Ectoderm
- Notochord
- Sclerotome
- Dermatome
C. Sclerotome
In RA study, the incidence rate is low but the prevalence is high. What is the cause?
- Genetics
- Gender distribution
- Increased duration of disease
Which part of the spinal nerve innervates epaxial muscles?
- Dorsal primary ramus
- Ventral primary ramus
- Dorsal root
- Ventral root
An elderly aged woman with RA has gained weight recently. She is on steroid treatment. She has proteinuria and hypoalbuminemia. What would you most likely find in the kidneys?
- Amyloid
- Abscess
- Calculus
- Vasculitis
A) Amyloid (recall that primary or AL amyloidosis, which is associated with Ig light
chain deposition, occurs in plasma call disorder or multiple myeloma. Secondary or AA amyloidosis, which is associated with serum amyloid A, is found in chronic diseases like RA, IBD, etc..)
Positive PAS cytoplasmuc accmulation?
Pompe’s disease
Rimmed vacuoles?
- Duchenne muscular dystrophy
- Inclusion body myositis
B. Inclusion body myositis
Which of the following is associated with mortality?
- SLE and RA
- untreated OA
A. SLE and RA
Which of the following results in muscle dystrohpy due to mutation iin dystrophin gene?
Duchenne muscle dystrophy
Which deformity of the spine can result from the presence of hemivertebra?
Scoliosis
What is associated with HLA-DR4 gene?
RA
What deformity can result in newborns from affected SCM muscle?
Torticollis
What forms the stem of the bottle-brush structure of proteoglycans?
Hyaluronic acid
What forms the lateral border of cubital fossa?
Brachioradialis
What mediate the tissue damage in RA?
TH1 and immune complexes
A man encounters an accident and thereis disk prolapse. He lost sensation over the radial part of the forearm and the thumb. Where is the prolapse?
C5-C6
What explains the reduction in mortality amoung RA patients?
introduction of DMARDS
Which part of long bones develops from primary ossification center?
Diaphysis
The common interosseous artery is a branch of which artery?
Ulnar artery
Epaxial muscle are supplied by which of the following
- Dorsal rami
- Ventral rami
- Dorsal root
- Ventral root
A. Dorsal Rami
Which bones from the surface that articulates with the radius att the wrist joint?
- Triquitrium
- Lunate
- Scaphoid
Injury to which nerve causes the loss of opposition of the thumbs?
Median Nerve
What is the sensory supply to the dorsal aspect of the foreram?
Radial nerve
If a patient is unable to extend at wrist and hand joints (i.e. wrist drop), at which level is the injury?
Shaft of the humerus
These fragments are early markers for osteoarthritis
Origin of verebral column
A man can’t oppose his 5th digit. Which muscle is affected?
opponens digiti minimi
Which of the following muscles causes flexion and abduction of hand?
- Flexor carpi radialis
- Flexor carpi ulnaris
A. Flexor carpi radialis
Which of the following findings is seen in osteoarthritis in the distal inter-phalngeal joints?
- Heberden’s node
- Bouchard’s node
- Rhematoid node
A.
What is the function of AGGRECAN
What is the early marker of joint disease in OA?
- Hyaluronic acid
- N-acetylglucosamine
- Collagen type II
- Collagen type IV
A. Hyaluronic Acid
Which bones form the wrist joint?
- Trapezium-schapoid-hamate
- Trapezoid-schapoid-hamate
- Lunate-capitate-hamatate
- Lunate-triquitram-pisiform
- Scaphoid-lunate- triquetrum
E. Scaphoid-lunate- triquetrum
Which nerve is compressed in carpal tunnel syndrome?
- Median Nerve
- Ulnar Nerve
- Radial Nerve
- Musculocutanous Nerve
- Med-cutaneous Nevre
A. Median Nerve
What is associated with RA?
A 16-year-old boy presented wutha stab injury in the cubital fossa, which nerve is most likely affected?
- Ulnar Nerve
- Radial Nerve
- Median Nerve
- Musculocutaneous Nerve
- Axillary Nerve
C. Median Nerve
What is targeted in the antibody therapy for RA?
- IL1-5
- IL10
- TNF-alpha
- INF-gamma
C. TNF alpha
A decrease in what cuases accelerated cartilage breakdown?
TIMPs
Why don’t we have a primary prevention for RA?
- The cause is not well understood
- High Costs
- Low prevalence of disease
A. The cause is not well understood
What is the immunopathogenesis in RA?
- Autoantibodies + macrophages
- Cytotoxic cells
- Natural Killer cells
A. Autoantibodies + macrophages
Which bone heals slowly due to less blood supply?
Scaphoid
What is embryological origin of myotomes?
- Paraxial mesoderm
- Intermediate mesoderm
- Lateral mesoderm
- Endoderm
A. Paraxial mesoderm
Injury to which of the following will affect the function of the subclavius?
Nerve to Subclavius
What deformity will result when the ulnar nerve is injured?
- Claw hand of the little and ring fingers
- Claw hand of the lateral fingers
Claw hand of the little and ring fingers
What histological features indicates the loss of motor neuron function?
- Group Muscle cell atrophy
- Muscle cell has vacuoles
- Adipocytes between muscles cells
- Small cells with central nuclei
- Muscle cell hyperplasia
A. Group Muscle cell atrophy
An increase in its levels will lead to accelerated degradations of cartilage
ADAMTs
Which cytokine is a target for inhibition in RA?
- IL-1
- IL-2
- IL-4
- IL-10
- INF-gamma
- TNF-alpha
E. INF-gamma
A patient has a skin rash with multiple joints swelling, upon examination of the synovial fluid, silver stain showed a spirochete
Lyme Disease
A biopsy of a nodule from the ear lobe of a patient was examined under microscope. There was a granulomatous reaction surrounding a clear space?
Gouty Arthritis
What describes the pathophysiology of RA?
- Th1 cells and immune complexes
- Th1 and NK cells
A. Th1 cells and immune complexes
What is responsible for the extended structure of proteoglycans?
Deposition of immune complex in RA induces what?
- Ab formation
- inflammation
- Th2 cytokine production
A person with laceration in the anterior compartment of the wrist and hand, had nothing wrong with the motor but sensory loss above the thumb part of the palmar area, which nerve is severed?
- Median Nerve
- Radial Nerve
- Ulnar Nerve
- Musculocutaneous Nerve
A. Median Nerve
Higher production of which component after trauma or mechanical stress may lead to the development of osteoarthritis?
- collagen II
- collagen IV
- aggrecan
- linking protein
- hyaluronic acid
- TIMPs
- ADAMTs
- glucosamine
G. ADAMTs
Which of the following when it decreases, stimulates cartilage fragmenting?
- collagen II
- collagen IV
- aggrecan
- linking protein
- hyaluronic acid
- TIMPs
- ADAMTs
- glucosamine
F. TIMPs
In the bottlebrush structure of proteoglycans, what forms the stem?
- Linker protein
- Hyaluronic acid
- Mylase
- Collagen type 2
B. Hyaluronic Acid
A Case of 5 years old boy, can’t play with his friends, he had elevated creatinine kinase (and other things indicating Duchenne muscular dystrophy with fibrosis). How would you confirm diagnosis?
- immunostaining of Dystrophin
- PCR for the gene XR27
A. immunostaining of Dystrophin
A 30 years old patient presented w/Heavy eyelids and progressive muscle weakness for 3-5 weeks. What will we find?
- increased Antibodies to acetylcholine
- elevated CK
- loss of dystrophin staining
A. increased Antibodies to acetylcholine
Injury to which nerve cause loss of sensation in the lateral side of forearm?
Musculocutaneous nerve
A 16-year-old child presented with a fracture of the medial epicondyle. Which nerve is most likely affected?
- ulnar nerve
- radial nerve
- median nerve
- musculocutaneous nerve
A. Ulnar nerve
A woman presents with right knee pain, swelling and pain of fingers in the morning. What is the diagnosis?
RA
What is the mechanism of Immune complex induced damage in RA?
Inflammation inducing TH2 cytokines
If there’s a displacement of the olecranon process, what movement would likely be lost?
A) Extension of the elbow
B) Extension of the wrist and ulnar deviation
C) Extension of the wristband radial deviation
A 15-year old boy presented with suprachondylar fracture of the humerus, which nerve will most likely be affected?
- Ulnar
- Median
- Radial
- Axillary
- Musculocutaneous
B) Median
Which structure of the humerus is most painful in young man known to have tennis elbow?
- Medial epicondyle
- Lateral suprachondylar ridge
- Medial suprachondylar ridge
- Lateral epicondyle
D. Lateral epicondyle
Regenerative muscle fiber
compression injury to ventral rami of C6 will to lead to sensory deficit of which area: A) axillary region
B) medial side of the arm
C) lateral side of the arm
D) medial side of forearm E) Lateral side of forearm
E. Lateral side of forearm
Fracture to this part damage radial nerve
- head of humerus
- anatomical neck
- surgical neck
- medial epicondyle
- lateral epicondyle
- capitulum
- Shaft
G. Shaft
Fractures to this part damages ulnar nerve
- head of humerus
- anatomical neck
- surgical neck
- medial epicondyle
- lateral epicondyle
- capitulum
- Shaft
D. Medial Epicondyle
Which part of the femur develops from primary ossification center?
- Head
- Shaft
- Medial condyle
- Lateral condyle
36-year-old male present with laceration in 1st web space which structure is affected
- radial artery
- deep radial nerve
- median nerve
- ulnar nerve
Failure of one half of vertebra to develop leads to:
- Spina bifida
- Scoliosis
B. Scoliosis
Failure of fusion of vertebral arches leads to:
- Spina bifida
- Scoliosis
A. Spina bifida
What muscle is used to manually screw into a tree? (its like asking what is used for supination)
- Biceps brachi
- Triceps
A. Biceps brachi
Which is a contributing factor to osteoarthritis?
- Reduced TIMPs
- Reduced MMPs
- Reduced ADAMTs
A. Reduced TIMPs
What inflammatory cytokine secreted by macrophages that causes damage in rheumatoid arthritis?
- Anti-nuclear antibody
- TNF alpha
- TNF gamma
- Il-2
- Il-4
- IFN-Y
B. TNF alpha
What inflammatory cytokine secreted by T cells that causes damage in rheumatoid arthritis?
- Anti-nuclear antibody
- TNF alpha
- TNF gamma
- Il-2
- Il-4
- IFN-Y
F. IFN-Y
year-old male suffers from weak abduction and adduction if fingers, but no problem with flexion. There is loss of sensation in the palmar surface of ring finger and small finger. Which nerve is affected?
- Median nerve in carpal tunnel
- Median nerve between two heads of pronator there’s
- Ulnar nerve near pisiform
- Ulnar nerve posterior to medial epicondyle
C. Ulnar nerve near pisiform
Development of the musculoskeletal system:
- Hypoxial myotome -> ventral aspect -> innervation; ventral ramus
- Epaxial myotome -> dorsal aspect -> innervation; dorsal ramus