Msk And Soft Tissue Path

Front 1

Monosodium urate crystals (MSU):

Back 1

yellow when parallel to slow ray of compensator

Front 2

Calcium pyrophosphate crystals (pseudogout):

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blue when parallel to slow ray of compensator

Front 3

Osteoarthritis

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degeneration articular cartilage; subchondral cysts; eburnation; osteophytes at margins

Front 4

Joints involved in OA

Back 4

weight bearing (femoral head); DIP joint (Heberden's nodes), PIP joints (Bouchard nodes)

Front 5

Neuropathic joint

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2° to neurologic disease: DM, syringomyelia, tabes dorsalis

Front 6

Rheumatoid arthritis (RA):

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female dominant; HLA Dr4

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RF for rheumatoid arthritis

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IgM antibody against Fc portion IgG; causes inflammation of synovial tissue

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Pannus

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inflamed hyperplastic synovial tissue destroys articular cartilage; joint fusion

Front 9

Joints involved in RA

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MCP and PIP joints

Front 10

S/S of RA

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morning stiffness; ulnar deviation of hands; carpal tunnel (entrapped median nerve)

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Rx for RA

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methotrexate often used as initial therapy, aspirin

Front 12

Sjogren's syndrome

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destruction lacrimal and minor salivary glands; RA; anti-SSA/SSB

Front 13

S/S of Sjogren's syndrome

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dry eyes and dry mouth

Front 14

Caplan syndrome

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pneumoconiosis + rheumatoid nodules in lungs

Front 15

Felty's syndrome

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RA + splenomegaly with hypersplenism

Front 16

Gouty arthritis

Back 16

underexcretion uric acid; big toe first affected; tophus in soft tissue sign chronic gout

Front 17

Gout associations

Back 17

alcohol, Pb poisoning

Front 18

Tophus

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MSU (monosodium urate) crystals produce foreign body giant cell reaction next to joint

Front 19

Uricosuric agents

Back 19

probenecid and sulfinpyrazone

Front 20

Allopurinol

Back 20

dec synthesis uric acid; xanthine oxidase inhibitor

Front 21

Pseudogout

Back 21

involves knee; linear calcification in articular cartilage

Front 22

Ankylosing spondylitis

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HLA-B27 seronegative (RF negative) spondyloarthropathy; male dominant

Front 23

S/S of Ankylosing spondylitis

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sacroiliitis; bamboo spine causing kyphosis; aortitis; uveitis

Front 24

Associations with Ankylosing spondylitis

Back 24

C. trachomatis MC, psoriasis, ulcerative colitis, Shigella, Campylobacter, Yersinia

Front 25

Reiter's syndrome

Back 25

HLA-B27; Chlamydia urethritis; arthritis; conjunctivitis; Achilles tendon periostitis

Front 26

Osteomyelitis in children

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hematogenous spread of Staphylococcus aureus to metaphysic

Front 27

Osteomyelitis in HbSS

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Salmonella paratyphi

Front 28

Pseudomonas aeruginosa osteomyelitis

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puncture of foot when wearing rubber foot wear

Front 29

Tuberculous osteomyelitis

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usually involves vertebra (Pott's disease)

Front 30

Disseminated gonococcemia

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female dominant, C6-C9 deficiency

Front 31

Disseminated gonococcemia

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septic arthritis (knee); tendinitis/synovitis and skin pustules in feet/wrists

Front 32

Lyme disease

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bite from a Ixodes tick; Borrelia burgdorferi; reservoirs white footed mouse, white tailed deer

Front 33

Early S/S of Lyme disease

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: erythematous concentric rash (erythema chronicum migrans), Rx doxycycline

Front 34

Late S/S of lyme disease

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arthritis, Bell's palsy (often bilateral), myocarditis, Rx doxycycline

Front 35

Babesiosis

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carried by Ixodes tick; Babesia are intraerythrocytic parasites; hemolytic anemia

Front 36

Cat bite

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potential for Pasteurella multocida septic arthritis

Front 37

Osgood Schlatter's:

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inflammation proximal tibial apophysis at patellar tendon insertion; knobby knee

Front 38

Osteogenesis imperfecta

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AD; dec synthesis type I collagen; pathologic fractures; blue sclera

Front 39

Blue sclera

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reflection of choroidal veins

Front 40

Achondroplasia

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AD; impaired enchondral calcification and premature closure of epiphyses

Front 41

S/S of Achondroplasia

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normal head/vertebral column, short extremities

Front 42

Osteopetrosis

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AD/AR; osteoclast defect; too much bone; pathologic fractures

Front 43

Osteoporosis

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dec bone mass and density; pathologic fractures

Front 44

Postmenopausal osteoporosis

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estrogen deficiency- inc osteoclastic activity, dec osteoblastic activity

Front 45

S/S of osteoporosis

Back 45

vertebral compression fractures, Colles fracture

Front 46

Colles fracture

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fractured distal radius with dinner fork appearance

Front 47

Prevention of osteoporosis

Back 47

estrogen (under investigation), calcium, vitamin D, stress exercises (walking, weight lifting)

Front 48

Aseptic necrosis femoral head

Back 48

femoral head fracture, corticosteroids, sickle cell disease; MRI best test

Front 49

Scaphoid bone fracture

Back 49

aseptic necrosis in wrist bone

Front 50

Volkmann's ischemic contracture

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fracture of distal radius; damage to brachial artery and median nerve

Front 51

Legg-Perthe's disease

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aseptic necrosis of ossification center (femoral head) in children

Front 52

Paget's disease

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elderly males; lytic/blastic bone lesions produce thick, weak bone

Front 53

S/S of Paget's disease

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pathologic fractures; inc serum AP; inc risk for osteogenic sarcoma

Front 54

Osteoid osteoma

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radiolucent lesion in cortex proximal femur; nocturnal pain relieved by aspirin

Front 55

Osteogenic sarcoma

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adolescent male; RB suppressor gene association; distal femur; inc AP

Front 56

Radiograph of Osteogenic sarcoma

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"sunburst" appearance, Codman's triangle

Front 57

Ewing's sarcoma

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primitive neuroectodermal tumor; round cell tumor

Front 58

Radiograph of Ewing's sarcoma

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"onion skinning"

Front 59

Osteochondroma

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MC benign bone tumor; exophytic growth off metaphysis of distal femur

Front 60

Chondrosarcoma

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MC malignant cartilaginous tumor; pelvic bones, proximal femur

Front 61

Giant cell tumor

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epiphysis distal femur/proximal tibia; giant cells + neoplastic mononuclear cells

Front 62

Muscle weakness

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primary muscle disease, neurosynapse disease, neurogenic disease

Front 63

Duchenne's muscular dystrophy

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XR; deficiency dystrophin; inc serum CK at birth; waddling gait

Front 64

Dystrophin

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attaches portions of cell membrane to sarcomere; important in contraction

Front 65

Becker's dystrophy

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XR, defective dystrophin

Front 66

Myotonic dystrophy

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AD; trinucleotide repeat disorder; cannot release grip

Front 67

Myasthenia gravis

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autoantibody against acetylcholine receptors (type II); thymic hyperplasia B cells

Front 68

S/S of myasthenic gravis

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diplopia at end of day first sign; dysphagia solids/liquids upper esophagus; thymoma

Front 69

Dupuytren's contracture

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fibromatosis palmar fascia

Front 70

MC soft tissue tumor

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Lipoma

Front 71

MC adult sarcoma

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Liposarcoma

Front 72

MC childhood sarcoma

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Embryonal rhabdomyosarcoma

Front 73

Autoimmune disease

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loss of self-tolerance

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Serum ANA

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greatest sensitivity for detecting SLE

Front 75

SLE

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type III reaction; confirm with anti-dsDNA, anti-Sm

Front 76

S/S of SLE

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malar rash, photophobia, joint pain, fibrinous pericarditis, nephritic GN

Front 77

Drug-induced lupus

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procainamide, hydralazine; anti-histone antibodies

Front 78

Antiphospholipid antibodies

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lupus anticoagulant, anti-cardiolipin antibodies; vessel thrombosis

Front 79

PSS

Back 79

excess collagen; anti-topoisomerase antibodies

Front 80

S/S of PSS

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dysphagia solids/liquids, Raynaud's, intersitial lung disease, renal failure

Front 81

CREST

Back 81

centromere ab/calcinosis; Raynaud; esophageal dysmotility; sclerodactyly, telangiectasia

Front 82

Dermatomyositis/polymyositis

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inc serum CK; risk of malignancy

Front 83

Mixed connective tissue disease

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anti-ribonucleoprotein antibody

Front 84

Antibody against acetylcholine receptor

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myasthenia gravis

Front 85

Antibody against basement membrane

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Goodpasture's syndrome

Front 86

Antibody against endomysium and gliadin

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celiac disease

Front 87

Antibody against insulin and islet cell

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type I diabetes

Front 88

Antibody against intrinsic factor and parietal cell

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pernicious anemia

Front 89

Antibody against microsome and thyroglobulin

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Hashimoto's thyroiditis

Front 90

Antibody against mitochondria

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primary biliary cirrhosis

Front 91

Antibody against proteinase 3 of neutrophil (cANCA):

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Wegener's granulomatosis

Front 92

Antibody against myeloperoxidase of neutrophil (pANCA):

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microscopic polyangiitis

Front 93

Antibody against TSH receptor

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Graves disease