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250 Cards in this Set
- Front
- Back
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Name the layers of the epidermis from superficial to base
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stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum, stratum basalis
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This type of gland produces a holocrine secretion of sebum. Associated with hair follicle
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sebaceous gland
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This type of gland secretes sweat. Found throughout the body
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eccrine glands
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This type of gland produces milky viscid secretions that become odorous due to bacterial action. Do not become functional until puberty
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Apocrine glands
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Zona occludens are ____ junctions. They are composed of these two proteins
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tight, claudins and occludins
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Zona adherens are _____ junctions. Surround the perimeter just below zona occludens. Cadherins connect to _____
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intermediate, calcium
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Macula adherens are better known as ______. Autoantibodies to this structure produce what pathology?
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desmosome, pemphigus vulgaris
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What epithelial cell junctions are composed of keratin and desmoplakin?
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macula adherens (desmosome)
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These type of junctions allows adjacent cells to communicate for electric and metabolic functions
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gap junctions
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This maintains integrity of basement membrane by binding to laminin in BM
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integrin
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This structure connects cells to underlying extracellular matrix. Autoantibodies to this structure is seen in bullous pemphigoid
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hemidesmosome
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What three elements are injured in the unhappy triad?
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MCL, ACL, lateral meniscus
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Anterior and posterior in ACL and PCL refer to sites of ____ attachment
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tibial
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Positive anterior drawer sign indicates tearing of the ____
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ACL
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Abnormal passive abduction indicates a torn _____
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MCL
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A pudendal nerve block should be given at what bony landmark?
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ischial spine
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What bony landmark is used for lumbar puncture?
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iliac crest
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What are the four rotator cuff muscles?
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supraspinatus, infraspinatus, teres minor, subscapularis
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What muscle is most commonly injured with rotator cuff injury?
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supraspinatus --> abducts arm initially (before deltoid)
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What rotator muscle laterally rotates arm; pitching injury
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infraspinatus
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What rotator muscle adducts and laterally rotates the arm?
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teres minor
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What rotator muscle medially rotates and adducts arm?
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subscapularis
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Names the wrist bones
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Scaphoid, lunate, triquetrum, pisoform, trapezium, trapezoid, capitate, hamate
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Fall on outstretched hand may cause fracture of what bone?
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scaphoid
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What root of the brachial plexus is mostly likely compressed by cervical disk lesion
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C7
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Which trunk of the brachial plexus is compressed by cervical rib or by Pancoast tumor of lung. Leads to Klumpke's palsy
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lower trunk
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This nerve could be compromised by a lesion of the surgical neck or dislocation of the humerus
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axillary nerve
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This nerve can be lesioned by midshaft fracture of humerus
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radial nerve in spiral groove
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This nerve can be stretched by subluxation of the radius
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radial nerve, deep branch
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This nerve would be compressed by supracondylar fracture of humerus; leads to pronator teres syndrome
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median nerve
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Lesion of this nerve can happen with fracture of the medial epicondyle of humerus
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ulnar nerve
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This nerve is compressed in carpal tunnel syndrome and by a dislocated lunate
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median nerve
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What dermatome represents the thumb?
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C6
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What nerve supplies the interossei and adductor pollicis?
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deep ulnar nerve
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What nerve travels in Guyon's canal?
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ulnar nerve
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Severing of the upper trunk will lead to what condition that is characterized by loss of supination and the arms hangs by side with the forearm extended and pronated. Can result from difficult childbirth
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Waiter's tip (Erb's palsy)
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Claw hand (Klumpke's palsy) is due to a lesion of what nerve?
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ulnar nerve
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Wrist drop is due to lesion of what nerve?
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radial nerve
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Winged scapula is due to injury to what nerve?
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long thoracic nerve
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Wrist drop can occur from what type of metal poisoning?
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lead
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Deltoid paralysis is caused by damage to the ____ nerve leading to loss of abduction and flat shoulder deformity
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axillary nerve
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Decreased thumb function and Pope's blessing is due to a lesion of the ___ nerve
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median
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The axillary nerve has contributions from what nerve roots?
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C5, C6
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Damage to this nerve can occur due to fracture of the surgical neck of humerus, dislocation of humeral head. Will lead to motor deficit of deltoid
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axillary nerve
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The radial nerve has contributions from what roots?
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C5-T1
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Damage to radial nerve will cause what motor deficits?
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brachioradialis, extensors of wrist and fingers, supinator, triceps
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Damage to this nerve will cause sensory deficit to posterior arm and dorsal hand/thumb and also wrist drop
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radial
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Fracture of supracondlylar humerus will lead to injury of what nerve
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median
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A proximal or distal lesion of the median nerve will lead to sensory deficit of the thenar eminence leading to Ape hand, or thenar atrophy, loss of opposability of thumb?
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proximal lesion
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Lesion of this nerve will occur with a fracture of the hook of hamate (falling onto outstretched hand)
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ulnar
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Radial deviation of wrist upon wrist flexion can occur with proximal or distal lesion of ulnar nerve?
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proximal
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Deficit of flexion of arm at the elbow can be caused by a lesion of what nerve?
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musculocutaneous nerve
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A presentation of limb hanging by side (due to paralysis of abductors), medially rotated and forearm is pronated is due to injury of what trunk of brachial plexus?
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upper
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Klumpke's palsy and thoracic outlet syndrome affects the ____ trunk of brachial plexus and can be caused by cervical rib compression
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inferior
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This pathology results in atrophy of thenar and hypothenar eminences, atrophy of interosseous muscles, sensory deficits on the medial side of forearm and hand, disappearance of the radial pulse upon moving the head toward the ipsilateral side
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thoracic outlet syndrome
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Ape hand is caused by a proximal median nerve lesion leading to loss of _____ muscle function yielding unopposable thumb (inability to abduct thumb)
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opponens pollicis
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What are the actions of the lumbricals?
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flex at MCP joint, extend at PIP and DIP joint
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This nerve can be injured in mastectomy
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long thoracic nerve
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The opponens pollicis, abductor pollicis brevis and flexor pollicis brevis are innervated by what nerve?
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median nerve
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The opponens digiti minimi, abductor digiti minimi, and flexor digiti minimi are innervated by what nerve?
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ulnar nerve
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The dorsal interosseous muscles ____ the fingers whereas the palmar interosseous muscles _____ the fingers
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abduct, adduct
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The adductor pollicis is innervated by what nerve?
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ulnar
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The dorsal interosseous muscles ____ the fingers whereas the palmar interosseous muscles ____ the fingers
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abduct, adduct
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Anterior hip dislocation will cause injury to what nerve leading to difficulty in thigh adduction and sensory deficit of the medial thigh
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obturator nerve (L2-L4)
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Pelvic fracture will cause injury to this nerve that will cause a deficit in thigh flexion and leg extension, and have a sensory deficit of the anterior thigh and medial leg
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femoral nerve (L2-L4)
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Trauma to the lateral aspect of the leg or fibula neck fracture will cause injury to this nerve, leading to foot eversion and dorsiflexion; toe extension; foot drop, foot slap, steppage gait. The sensory deficit is on the anterolateral leg and dorsal aspect of foot
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common peroneal (L4-S2)
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Knee trauma will cause injury to this nerve leading to foot inversion and plantarflexion deficit, as well as toe flexion. Sensory deficit of the sole of foot
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tibial nerve (L4-S2)
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Posterior hip dislocation or polio can cause injury to what nerve?
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superior gluteal (L4-S1)
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Positive Trendelenburg sign --> contralateral hip drops when standing on leg ipsilateral to site of lesion is caused by injury to what nerve?
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superior gluteal
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With injury to this nerve one can't jump, climb stairs, or rise from seated position. Can't push inferiorly (downward)
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inferior gluteal (L5-S2)
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Foot drop is caused by injury to what nerve?
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peroneal nerve
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The tibial nerve inverts and plantarflexes. If injured the person cannot stand on their tiptoes. True or False?
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true
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What nerve splits into the common peroneal and tibial nerve?
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sciatic nerve
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Depolarization of the voltage sensitive dihydropyridine receptor, coupled to the ryanodine receptor on the SR induces a conformation change causing _____ release from SR
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Calcium
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Released calcium binds to troponin ____, causing a conformational change that moves ______ out of the myosin biding groove on actin filaments
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C, tropomyosin
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Contraction results in __ and ___ band shortening, but the ___ band remains the same length
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H and I, A band
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A sarcomere runs from what line to what line?
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Z line to Z line
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Thick filaments are present in the ___ band in the center of the sarcomere, and contains myosin
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A
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Thin filaments are anchored at ___ lines. Are present in the ____ bands
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Z lines, I
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These muscles are slow twitch and have red fibers due to increased mitochondria and myoglobin concentration (leads to increased oxidative phosphorylation). Will have sustained contraction
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Type I muscles
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These muscles are fast twitch. They have white fibers due to decreased mitochondria and myoglobin concentration (increased anaerobic glycolysis). Weight training results in hypertrophy of these fibers
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Type II muscles
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Myosin is tightly bound to actin. In the absence of ATP this state is permanent and termed _____
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rigor mortis
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What constitutes the power stroke?
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Myosin attaches to new site on actin, ADP is released
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With smooth muscle contraction calcium binds to calmodulin which activates this enzyme
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myosin light chain kinase which phosphorylates myosin light chains leading to cross-bridge formation with contraction
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Activation of the enzyme myosin light chain phosphatase will lead to relaxation or contraction?
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relaxation
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Nitric oxide stimulates ____ which produces cGMP
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guanylate cyclase
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This type of bone ossification is important in longitudinal bone growth. Cartilagionous model of bone is first made by chondrocytes. Osteoclasts and osteoblasts later replace with woven bone and remodel to lamellar bone
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Endochondral ossification
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This type of ossification generates flat bone growth (skull, facial bones, and axial skeleton). It is woven bone formed directly from cartilage. Later remodeled to lamellar bone
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membranous ossification
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Osteoblasts arise from mesenchymal stem cells in the ______
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periosteum
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In achondroplasia is endochondral or membranous ossification affected?
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endochrondral
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In achondroplasia there is constitutive activation of _____ which inhibits chondrocyte proliferation
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fibroblast growth factor receptor
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Achondroplasia has what mode of inheritance. Common cause of dwarfism but with normal life span and fertility
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autosomal dominant
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Vertebral crush fractures that can lead to acute back pain, loss of height and kyphosis can result from what condition?
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osteoporosis
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This type of osteoporosis occurs post menopause with increased bone resorption due to low estrogen levels
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Type I
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Senile osteoporosis or Type II osteoporosis can be treated with what type of drugs?
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SERMs and/or calcitonin; bisphosphonates or pulsatile PTH. Glucocorticoids are contraindicated
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This pathology is characterized by failure of normal bone resorption. Leads to thickened, dense bones that are prone to fracture. Bone defect is due to abnormal function of osteoCLASTS
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osteopetrosis
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In this bone pathology serum calcium, phosphate, and alkaline phosphatase are normal. Primary spongiosa fills medullary cavity resulting in decreased marrow space leading to anemia and thrombocytopenia, infection
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osteopetrosis
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With this bone pathology there is increased extramedullary hematopoiesis. There is a genetic deficiency of carbonic anhydrase II. X-rays show Erlenmeyer flask bones that flare out. Can result in cranial nerve impingment and palsies due to narrowed foramina
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osteopetrosis
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This disease is characterized by defective mineralization/calcification of osteoid leading to soft bones. Results from Vitamin D deficiency leading to decreased calcium levels and increased secretion of PTH, and a decrease in serum phosphate. Reversible when Vitamin D is replaced.
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osteomalacia/rickets
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This disease is characterized by abnormal bone architecture caused by increase in both osteoblastic and osteoclastic activity. Possibly viral in origin (paramyxovirus suspected). Increase in alkaline phosphatase.
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Pagets disease
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With this bone pathology there can be increased blood flow from increased AV shuts that can cause high output heart failure. Can lead to osteogenic sarcoma. Hearing loss is common due to auditory foramen narrowing
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Pagets disease
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This pathology is defined by bone being replaced by fibroblasts, collagen, and irregular bony trabeculae.
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polyostotic fibrous dysplasia
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This syndrome is a form of polyostotic fibrous dysplasia characterized by multiple unilateral bone lesions associated with endocrine abnormalities (precious puberty) and cafe-au-lait spots
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McCune-Albright syndrome
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This tumor is common in people 20-40 years of age and is located in the epiphyseal end of long bones. It is a locally aggressive benign tumor often around the distal femur or proximal tibial region (knee). It has a soap bubble appearance on x-ray. There are spindle shaped cells with multinucleated giant cells
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giant cell tumor (osteoclastoma)
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This bone tumor is the most common benign tumor and is seen in men less than 25 years of age. There is mature bone with cartilaginous cap. Commonly originates from long metaphysis. Malignant transformation to chondrosarcoma is rare
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Osteochondroma
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This is the 2nd most common primary malignant bone tumor. Predisposing factors include Paget's disease of bone, bone infarcts, radiation, and familial retinoblastoma. Seen in the metaphysis of long bones, often around distal femur, proximal tibial region (knee)
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osteosarcoma
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This bone tumor is found in boys under 15 years of age. Commonly appears in the diaphysis of long bones, pelvis, scapula and ribs. Described as an anaplastic small blue cell malignant tumor.
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Ewings sarcoma
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This tumor is defined by a Codman's triangle or sunburst pattern on x-ray. There is a poor prognosis.
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Osteosarcoma
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This tumor is extremely aggressive with early metastases but is responsive to chemotherapy. There is an onion skin appearance in bone. Also defined by 11:22 translocation
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Ewing's sarcoma
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This primary bone tumor occurs in men 30-60 years of age. Usually located in the pelvis, spine, scapula, humerus, tibia or femur. It is a malignant cartilaginous tumor. May be of primary origin or from osteochondroma. Seen as expansile glistening mass within the medullary cavity
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Chondrosarcoma
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Subchondral cysts, sclerosis, osteophytes (bone spurs), eburnation (polished, ivory-like appearance of bone), Heberden's nodes and Bouchard's nodes are all seen in what pathology?
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osteoarthritis
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Classic presentation of this pathology is pain in weight bearing joints after use (at end of day), improving with rest. In knees, there is cartilage loss beginning on the medial aspect ("bowlegged"). Noninflammatory. No systemic symptoms
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osteoarthritis
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This is an autoimmune inflammatory disorder affecting synovial joints with pannus formation in the joints (MCP, PIP, does not effect DIP)
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rheumatoid arthritis
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Fibrinoid necrosis surrounded by palisading histiocytes, ulnar deviation, subluxation, Baker's cyst can be manifestations of what pathology?
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rheumatoid arthritis
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What type of hypersensitivity defines rheumatoid arthritis?
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Type III
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Rheumatoid factor is an anti-_____ antibody
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IgG
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Anti-CCP antibody is specific for what pathology that has a strong association with HLA-DR4?
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RA
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Systemic symptoms of RA can include?
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fever, fatigue, pleuritis, pericarditis, amyloidosis can result leading to restrictive cardiomyopathy
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Boutonniere deformity is seen in what pathology?
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RA
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Swan neck deformity and Z-thumb deformity is seen in what pathology?
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RA
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NSAIDs, COX-2 inhibitors, glucocorticoids, disease-modifying drugs (methotrexate, sulfasalazine, and hydroxycholoroquine) are used to treat what disease?
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RA
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This classic triad is seen in this syndrome: Xerophthalmia (dry eyes, conjunctivitis, "sand in my eyes"), Xerostomia (dry mouth, dysphagia), and Arthritis
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Sjogren's syndrome
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This syndrome is characterized by dry eye, dry mouth, nasal and vaginal dryness, chronic bronchitis, reflux esophagitis but no arthritis
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Sicca syndrome
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This syndrome presents with parotid enlargement, increased risk of B-cell lymphoma, dental caries. There are autoantibodies to ribonucleoprotein antigens, SS-A (Ro), SS-B (La)
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Sjogren's syndrome
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Tophi in joints (aggregates of urate crystals surround by inflammation) is found in what pathology?
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gout
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Precipitation of monsodium urate crystals into joints due to hyperuricemia, which can be caused by Lesch-Nyhan syndrome, PRPP excess, and decreased excretion of uric acid (thiazide diuretics) can lead to this pathology
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Gout
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Von Gierke's disease and Lesch-Nyhan syndrome can predispose to what pathology?
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gout
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How much of gout is due to underexcretion versus overproduction?
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90% underexcretion and 10% overproduction
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This pathology is defined by crystals that are needle shaped and negatively birefringent = yellow crystals under parallel light. More common in men
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gout
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Tophus formation is common in what areas for gout?
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external ear, olecranon bursa, or Achilles tendon
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Acute attacks of this pathology which is defined by tophi in joints usually occur after a large meal or alcohol consumption
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gout
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What should one treat with for acute gout? chronic gout?
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acute= NSAIDs (indomethacin) and colchicine. for chronic gout treat with allopurinol, febuxostat, and uricosurics (ex. probenecid)
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This condition is caused by deposition of calcium pyrophosphate crystals within joint space. Forms basophilic, rhomboid crystals that are weakly positively birefringent.
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pseudogout
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Pseudogout usually affects what type of joints?
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large joints, usually knee
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With gout crystals are ____ under parallel light and blue when ____ to the light. With pseudgout crystals are _____ when perpendicular and blue when _____ to the light
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yellow, perpedicular, yellow, parallel
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Septic arthritis can commonly be caused by what organisms?
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S. aureus, Streptococcus, and neisseria gonorrhoeae
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Gonoccocal arthritis usually affects one or many joints?
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poly-articular, migratory arthritis with asymmetrical pattern
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Chronic infectious arthritis is usually caused by what two organisms?
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TB, Lyme disease
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This pathology is defined by infarction of bone and marrow. Pain associated with activity. Caused by trauma, high dose corticosteriods, alcoholism and sickle cell
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Osteonecrosis (avascular necrosis)
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Seronegative spondyloarthropathies have a strong association with what HLA subtype?
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HLA-B27
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Name the 4 common spondyloarthropathies
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psoriatic arthritis, ankylosing spondylitis, inflammatory bowel disease, reactive arthritis
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This spondyloarthropathy s defined by asymmetric and patchy involvement. There is dactylitis ("sausage fingers"), "pencil-in-cup" deformity on x-ray.
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psoriatic arthritis
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This spondyloarthropathy is defined by chronic inflammatory disease of spine and sacroiliac joints --> ankylosis (stiff spine due to fusion of joints), uveitis, and aortic regurgitation. Also see bamboo spine
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ankylosing spondylitis
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The classic triad with this disease is conjunctivitis and anterior uveitis, urethritis, and arthritis. Occurs post-GI or chlamydia infections
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reactive arthritis (Reiter's syndrome)
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Symptoms of this condition include fever, fatigue, weight loss, Libman-Sacks endocarditis (verrucous, wart-like, sterile vegetations on both sides of valve), hilar adenopathy and Raynauds phenomenon
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lupus
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With this pathology ones see wire loop lesions in kidney with immune complex deposition. One can get death from renal failure and infections
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SLE
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Having this pathology will lead to a false positive on syphilis tests due to antiphospholipid antibodies, which cross-react with cardiolipin used in tests
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SLE
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Antinuclear antibodies, anti-dsDNA antibodies indicate what pathology?
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SLE
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Anti-Smith antibodies indicate what pathology?
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SLE
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Antihistone antibodies suggest what pathology?
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drug induced lupus
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This pathology is characterized by immune-mediated widespread noncaseating granulomas and elevated serum ACE levels. Common in black females.
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Sarcoidosis
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This pathology is associated with restrictive lung disease, bilateral hilar lymphadenopathy, erythema nodosum, Bell's palsy, epithelial granulomas containing microscopic Schaumann and asteroid bodies, uveoparotitis and hypercalcemia.
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Sarcoidosis
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This pathology is associated with pain and stiffness in shoulders and hips, often with fever, malaise and weight loss. Does not cause muscle weakness. Occurs in patients older than 50 years of age. Associated with temporal (giant cell) arteritis
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Polymyalgia rheumatica
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In polymyalgia rheumatics there is an ____ ESR and ____ CK
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increased ESR, normal CK
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What is the treatment for Polymyalgia rheumatica?
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prednisone
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This pathology is mostly seen in women 30-50 years of age. Widespread musculoskeletal pain associated with stiffness, paresthesia, poor sleep, and fatigue. Must have more than 11 of 18 tender points.
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Fibromyalgia
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This disease presents with progressive symmetric proximal muscle weakness caused by CD8+ T cell induced injury to myofibers. Most often involves shoulders
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Polymyositis
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Does polymyositis or dermatomyositis present usually with difficulty ascending stairs and rising from seated position?
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Polymyositis
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This pathology involves a malar rash. There are also Gottron's papules, "shawl and face" rash, "mechanic's hands". There is increased risk of malignancy and muscle biopsy shows perifascicular atrophy
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dermatomyositis
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Finding with polymyositis and dermatomyosities include ___ CK, ____ aldolase and positive ANA, anti-JO1
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increased, increased
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How do you treat polymyositis and dermatomyositis?
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steroids
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This is the most common NMJ disorder. There are autoantibodies to postsynaptic AChR causing ptosis, diplopia, and general weakness.
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Myasthenia gravis
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This NMJ disorder is associated with thymoma. Symptoms worsen with muscle use. Reversal of symptoms occurs with AChE inhibitors (edrophonium test distinguishes under and overdosing)
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Myasthenia gravis
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This disease is defined by excessive fibrosis and collagen deposition throughout the body. Commonly sclerosis of skin, manifesting as puffy and taut skin with absence of wrinkles.
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Scleroderma
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This type of pathology is defined by anti-Scl-70 antibody (anti-DNA topoisomerase I antibody). There is widespread skin involvement, rapid progression and early visceral involvement.
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diffuse scleroderma
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CREST syndrome is defined by what pathologies and what antibody?
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anti-centromere antibody, calcinosis, raynauds, esophageal dysmotility, sclerodactyly, and telangiectasia
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A flat discoloration that is less than 1 cm and is seen in tinea versicolor is termed a ____
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macule
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A macule that is greater than 1 cm is termed a ____
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patch
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An elevated skin lesion that is less than 1 cm is termed a _____
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papule, seen in acne vulgaris
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A papule that is greater than 1cm is termed a ___ and an example is psoriasis
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plaque
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A small fluid containing blister such as chickenpox is termed a _____
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vesicle
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This is a transient papule/plaque that is seen in hives
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Wheal
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This is a large fluid containing blister that can be seen in bullous pemphigoid
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bulla
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Examples of this lesion are seen in T. pertenue (yaws).. There are irregular, raised lesions resulting from scar tissue hypertrophy (follows trauma to skin, especially in African Americans)
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Keloid
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Blister containing pus is termed _____
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pustule
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Dried exudates from a vesicle, bulla, or pustule is commonly called crust and is commonly seen with _____
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impetigo
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What is hyperkeratosis? See it in psoriasis
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increased thickness of stratum corneum
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What is parakeratosis? See it in psoriasis
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increased thickness of stratum corneum with retention of nuclei
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Acantholysis is what and is seen in what pathology?
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separation of epidermal cells and seen in pemphigus vulgaris
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What are the characteristics of acanthosis?
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epidermal hyperplasia (increased spinosum)
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Inflammation of the skin is termed _____
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dermatitis
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Warts are soft, tan colored, cauliflower-like lesions. Characterized by hyperplasia, hyperkeratosis, and koilocytosis. Verruca vulgaris on hands; condyloma acuminatum on genitals caused by ______
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HPV
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A nevocellular nevus is benign or malignant?
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common mole, benign
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Urticaris is better known as ____, intensely pruritic wheels that form after mast cell degranulation
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hives
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Ephelis is better known as ____. Normal number of melanocytes but increased melanin pigment
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freckle
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This is a pruritic eruption, commonly on skin flexures. Often associated with other atopic diseases such as asthma and allergic rhinitis
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atopic dermatitis (eczema)
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Type IV hypersensitivity reaction that follows exposure to allergen. Lesions occur at site of contact (eg. nickel, poison ivy)
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allergic contact dermatitis
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This is defined by papules and plaques with silvery scaling, especially on knees and elbows. One sees acanthosis with parakerototic scaling. There is increased stratum spinosum but decreased stratum granulosum
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Psoriasis
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Auspitz sign and nail pitting are associated with what pathology?
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psoriasis
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This is a flat, greasy, pigmented squamous epithelial proliferation with keratin filled cysts (horn cysts). Looks "pasted on". Lesions occur on head, trunk, and extremities. Common benign neoplasm of older persons
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Seborrheic keratosis
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Sign of Leser-Trelat is the sudden appearance of multiple seborrheic keratosis indicating an underlying malignancy such as ____
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GI or lymphoid
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With seborrheic keratosis, _____ should be part of the differential diagnosis
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melanoma
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This condition is defined by normal melanocyte number with decreased melanin production due to decreased activity of tyrosinase. Can also be caused by failure of neural crest cell migration during development
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Albinism
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Albinism has a normal or abnormal melanocyte number?
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normal, but lack of pigmentation is caused by decreased melanin production due to decreased activity of tyrosinase
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This is an irregular area of complete depigmentation. Caused by a decrease in melanocytes
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vitiligo
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This is defined by hyperpigmentation associated with pregnancy or oral contraceptive use
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melasma (chloasma)
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Is albinism or vitiligo characterized by a decrease in melanocytes?
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vitiligo
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This is a very superficial skin infection. Usually from S. aureus or S. pyogenes. Highly contagious. Honey-colored crusting
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Impetigo
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This is an acute, painful spreading infection of dermis and subcutaneous tissues. Usually from S. pyogenes or S. aureus
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Cellulitis
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This is a deeper tissue injury, usually from anaerobic bacteria and S. pyogenes. Results in creptus from methane and CO2 production. "Flesh-eating bacteria"
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necrotizing fasciitis
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In this syndrome, an exotoxin destroys keratinocyte attachments in the stratum granulosum only. Characterized by fever and generalized erythematous rash with sloughing of the upper layers of the epidermis. Seen in newborns and children
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Staphylococcal scalded skin syndrome (SSSS)
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This is a white, painless plaque on the tongue that cannot be scraped off. EBV mediated. Occurs in HIV-positive patients
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Hairy leukoplakia
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This potentially fatal autoimmune disorder is characterized by IgG antibody against desmosomes.
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Pemphigus vulgaris
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With this pathology immunofluorescence reveals antibodies around cells of epidermis in a reticular or netlike pattern. There are flaccid blisters involving the skin and oral mucosa. There is a positive nikosky's sign (separation of epidermis upon manual stroking of skin)
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pemphigus vulgaris
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Is it in pemphigus vulgaris or bullous pmphigoid that there is detachment from the basement membrane?
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bullous pemphigoid
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This is an autoimmune disorder with IgG antibody against hemidesmosomes. Show linear immunofluorescence. There are eosinophils within tense blisters. Similar to but less severe than pemphigus vulagris --> affects skin but spares oral mucosa. There is a negative Nikolsky's sign
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Bullous pemphigoid
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Does Bullous pemphigoid or pemphigus vulgaris spare the oral mucosa from blisters?
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Bullous pemphigoid
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This pathology is characterized by pruritic papules and vesicles. Deposits of IgA at the tips of dermal papillae. Associated with celiac disease
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Dermatitis herpetiformis
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Sulfa drugs, beta-lactams and phenytoin can cause erythema ____
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multiforme
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This pathology is characterized by fever, bulla formation and necrosis, sloughing of skin, and a high mortality rate. Usually associated with adverse drug reaction. More severe form is toxic epidermal necrolysis
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Stevens-Johnson syndrome
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This pathology is characterized as being pruritic, purple, and having polygonal papules
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lichen planus
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This skin disorder is characterized by a sawtooth infiltrate of lymphocytes at the dermal-epidermal junction. It is associated with Hep C
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Lichen planus
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This is a pre-malignant lesion caused by sun exposure. Also there is a cutaneous horn. Risk of carcinoma is proportional to epithelial dysplasia
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actinic keratosis
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With this skin disorder there is hyperplasia of the stratum spinosum. Associated with hyperinsulinemia and visceral malignancy
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Acanthosis nigricans
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Inflammatory lesion of subcutaneous fat usually on anterior shins. Associated with coccidiodomycosis, histoplasmosis, TB, leprosy, streptococcal infections, and sarcoidosis
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Erythema nodosum
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This skin disorder begins with a herald patch followed day later by a Christmas tree distribution. There are multiple papular eruptions; remits spontaneously
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Pityriasis rosea
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This skin cancer is associated withe excessive exposure to sunlight and arsenic. Commonly appears on hands and face. Locally invasive but rarely metastasizes. Histologically there are keratin pearls
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Squamous cell carcinoma
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What is the precursor to squamous cell carcinoma?
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actinic keratosis
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A _____ is a variant of squamous cell carcinoma that grows rapidly (4-6 weeks) and regresses spontaneously (4-8 weeks)
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keratoacanthoma
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This is most common in sun exposed areas of the body. Rolled edges with central ulceration. Pearly papules commonly with telangiectasias. Have palisading nuclei
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Basal cell carcinoma
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This tumor has the marker S-100. Depth of tumor correlates with risk of metastasis.
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Melanoma
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A dysplastic nevus (atypical mole) is a precursor to ____
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melanoma
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The lipoxygenase pathway yields _____
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leukotrienes
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LTB4 is a _____ chemotactic agent
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neutrophil
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This arachidonic acid product increases platelet aggregation, increases vascular tone and increases bronchial tone
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thromboxane
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This arachidonic acid product decreases platelet aggregation, decreases vascular tone, decreases bronchial tone, and decreases uterine tone
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prostacyclin (PGI2)
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What drug inhibits the lipoxygenase pathway?
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Zileuton
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This drug irreversibly inhibits COX1 and COX2 by acetylation. Increases bleeding time though there is no effect on PT, PTT. It is a type of NSAID
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aspirin
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A low dose of aspirin has what clinical use? Intermediate dose? High dose?
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low dose - decrease platelet aggregation, intermediate dose- antipyretic and analgesic, high dose: anti-inflammatory
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Toxicities of this drug include gastric ulceration, hyperventilation, and tinnitus (CN VIII). Chronic use can lead to acute renal failure, interstitial nephritis. Can also cause Reye's syndrome in children with viral infection
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aspirin
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Ibuprofen, naproxen, indomethacin, and ketorolac are what class of drugs?
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NSAIDs
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This drug is used to close a PDA
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indomethacin
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This drug has increased risk of thrombosis and can also lead to sulfa allergy. Less toxicity to GI mucosa compared to NSAIDs. Used to treat rheumatoid and osteoarthritis
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COX-2 inhibitors such as celecoxib
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This drug reversibly inhibits cyclooxygenase, mostly in the CNS. It is an antipyretic, analgesic but lack anti-inflammatory properties. Used instead of aspirin to prevent Reye's syndrome in children with viral infection
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acetaminophen
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Overdose of this drug produces hepatic necrosis; the metabolite of this drug depletes glutathoine and forms toxic tissue adducts in liver.
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Acetaminophen
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N-acetylcysteine is the antidote --> regenerate glutathione for this drug
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Acetaminophen
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Etidronate, pamidronate, alendronate, risedronate, and zoledronate are what class of drugs?
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bisphosphonates
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This class of drugs inhibit osteoclastic activity; reduce both formation and resorption of hydroxyapatite. They are used clinically to treat malignancy associated hypercalcemia, Pagets disease of bone, and postmenopausal osteoporosis
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bisphosphonates
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This class of drugs causes corrosive esophagitis, nausea, diarrhea, and osteonecrosis of the jaw
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bisphosphonates
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This gout drug inhibits reabsorption of uric acid in the PCT (also inhibits secretion of penicillin)
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probenecid
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This drug inhibits xanthine oxidase and decreases conversion of xanthine to uric acid. Also used in lymphoma and leukemia to prevent tumor lysis associated urate nephropathy.
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Allopurinol
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This drug will increase concentrations of azathioprine and 6-MP
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allopurinol
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One should not give what type of drug to gout patients?
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salicylates, all but the highest dose depress uric acid clearance
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|
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What is the mechanism of action of febuxostat?
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inhibits xanthine oxidase
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|
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What two drugs are used to treat acute gout?
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colchicine and NSAIDS
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What NSAIDs used to treat gout?
|
Naproxen
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This drug, which is used to treat gout, binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation
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colchicine
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This drug is a recombinant form of TNF receptor that binds TNF. It is a TNF decoy receptor. It is used to treat rheumatoid arthritis, psoriasis, and ankylosing spondylitis
|
Etanercept
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|
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This two drugs are anti-TNF antibodies
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Infliximab, adalimumab
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|
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All TNF-a inhibitors predispose to infection, including reactivation of _____
|
latent TB
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