Msk/rheum/derm Step 1

Front 1

Endochondral ossification vs membranous ossification

Back 1

Chondrocytes lay down cartilage frame first (axial skeleton), then membranous is where osteoblasts/osteoclasts lay down bone matrix directly without cartilage frame (skull/facial bones)

Front 2

Defect of echondral ossification in axial skeleton

Back 2

Achondroplasia (dwarfism)

Front 3

What mutation causes achondroplasia?

Back 3

Activation of FGF3 receptor. This inhibits chondrocyte proliferation, so they don't lay down cartilage frame correctly.

Front 4

Most common benign tumor of bone

Back 4

osteochondroma (young males < 25)

Front 5

"Soap bubble" appearance of bone with this tumor

Back 5

osteoclastoma - tumor of osteoclasts

Front 6

Codman triangle + sunburst appearance of bone

Back 6

X ray finding in osteosarcoma - tumor pushing up periosteum from surface of bone

Front 7

This cancer occurs in young boys < 15 and is extremely aggressive. Grows along corticol bone, associated with 11/22 translocation and gives onion skin appearance on x ray

Back 7

Ewing sarcoma - gives you an onion skin appearance

Front 8

What are the benign primary bone tumors? Malignant?

Back 8

osteochondria, osteoclastoma. Malignant - osteosarcoma and ewing sarcoma

Front 9

This primary bone tumor looks like there's a "chunk" of bone stuck around the knee

Back 9

Osteochondroma

Front 10

Which cancers metastasize to bone most commonly?

Back 10

Prostate, Renal cell cancer, Testes, Thyroid, Lung, Breast

Front 11

Prevention of osteoperosis

Back 11

Stop smoking/alcohol. Stop steroids if able, avoid PPI/H2 blockers if possible. Take bisphosphonates, exercise

Front 12

Which diuretic should you give to someone who has hypertension/CHF but also osteoperosis?

Back 12

HCTZ or other thiazides.

Front 13

Why is stopping PPIs/H2 blockers recommended to prevent osteoperosis?

Back 13

because you need acidic environment to absorb calcium

Front 14

Alendronate, Risendronate, Etidronate - what are these drugs and hwo do they work?

Back 14

Bisphosphonates. Inhibit osteoclasts to allow the osteoblasts to "catch up" and build more bone

Front 15

Side effects of bisphosphonates

Back 15

Erosive esophagitis, osteonecrosis of Jaw (very rare)

Front 16

Bisphosphonates are structural analogues of ____

Back 16

Pyrophosphate - a component of hydroxyapatite. Bisphosphanates make hydroxyapatite more soluble

Front 17

What is teriparatide? How is this used to treat osteoperosis?

Back 17

PTH analogue - reduces rate of fractures

Front 18

PTH, calcium and phosphorus levels in primary osteoperosis?

Back 18

Normal

Front 19

what is osteopetrosis?

Back 19

Rock like bones - very dense/thick bones. Defect of osteoclasts so you can't resorb bone

Front 20

What is the pathogenesis of osteopetrosis?

Back 20

Osteoclasts deficient in carbonic anhydrase II - can't break down bony matrix

Front 21

X ray showing bones "flaring out" at the ends because they're widened here. Patients can also have anemia/thrombocytopenia/low WBCs because of growth into marrow matrix

Back 21

osteopetrosis

Front 22

Bone specific alk phos reflects Osteoblastic or osteoclastic activity? What about urinary deoxypyridinoline?

Back 22

Osteoblast, osteoclast

Front 23

Disoragnanized, localized disorder of bone architecture due to increased osteoblastic and osteoclastic activity

Back 23

Paget disease of bone

Front 24

Increased hat size or hats getting too tight. Possibly some hearing loss due to narrowing of auditory foramen

Back 24

Paget disease of bone

Front 25

Increased risk of osteosarcoma in this disease of bone

Back 25

Paget disease of bone

Front 26

Increased activity of osteoclasts followed by increased osteoblastic activity and bony overgrowth

Back 26

Paget disease of bone

Front 27

Bony manifestation of endocrine disorder that can be caused by hyperparathyroidism and pseudohypoparathyroidism (in both cases, PTH is high)

Back 27

Osteitis fibrosa cystica

Front 28

RANK-L and M-CSF (macrophage colony stimulating factor) are released by ____ and are important for ____ formation

Back 28

Osteoblasts. Important for osteoclast formation

Front 29

Osteitis fibrosa cystica - what is the pathogenesis?

Back 29

Endocrine disorders leading to high pTH and therefore high osteoclastic activity. This causes "brown tumors" in bones, which are cystic spaces lined by osteoclasts filled with fibrous stroma/blood

Front 30

Bone replaced by collagen and fibroblasts

Back 30

Polyostotic fibrous dysplasia

Front 31

Fibrous dysplasia of bone (aka polyostotic fibrous dysplasia) is one part of triad in McCune Albright syndrome - what are the other two symptoms?

Back 31

Percocious puberty, cafe au lait spots, and fibrous dysplasia

Front 32

Elevated alk phos, but normal calcium, phosphate, PTH

Back 32

Paget disease of bone

Front 33

Most hip dislocations are

Back 33

posterior dislocation - femorl head slipping out of acetabulum posteriorly

Front 34

What vessels and nerves are damaged with posterior hip dislocations?

Back 34

Medial/lateral circumflex arteries (which surround femoral head), femoral vein, and femoral nerve

Front 35

MCL, ACL, and either lateral or medial meniscus damaged in this injury

Back 35

Unhappy triad - lateral force on knee with platned foot

Front 36

What are the two types of knee bursitis?

Back 36

Prepatellar bursitis ("housemaid's knee", infrapatellar burisits

Front 37

Most common ligament tear in ankle sprains

Back 37

anterior talofibular ligament (ATFL - Always tears first ligament)

Front 38

How do you treat ankle sprain?

Back 38

RICE - rest, ice, compression, elevation

Front 39

Pain in the medial arch of your foot or around your heal happening with first steps in the morning or after weight bearing

Back 39

Plantar fasciitis

Front 40

What are the 4 muscles of the rotator cuff?

Back 40

Supraspinatus - abduction, infraspinatus, teres minor, subscapularis

Front 41

Empty can test is testing which muscle?

Back 41

Supraspinatus

Front 42

Which rotator cuff muscles laterally rotate the shoulder? Medial rotator?

Back 42

Infraspinatus and teres minor, subscapularis is medial rotator

Front 43

Which structures can be damaged in anterior shoulder dislocation?

Back 43

Axillary nerve and posterior circumflex artery, supraspinatus tendon

Front 44

How do you test for axillary nerve injury?

Back 44

See if they have sensation on shoulder

Front 45

Adhesive capsulitis aka

Back 45

Frozen shoulder

Front 46

Achilles tendon rupture with these antibiotics

Back 46

Fluoroquinolones

Front 47

Tennis elbow vs "golfer elbow"

Back 47

Lateral epicondylitis. Leads to small tears in wrist extensor tendons that attach here (2) Medial epicondylitis. Inflammation of medial epicondyle, tears in wrist flexor tendons

Front 48

Tenderness in anatomic snuffbox - which bone is likely fractured? Risk following fracture?

Back 48

Scaphoid. risk of nonunion and avascular necrosis due to it's poor blood supply

Front 49

Eburnation of bone

Back 49

Bone getting "shiny" because of bone on bone due to osteoarthritis

Front 50

Osteophytes aka bone spurts found in PIP? DIP? these are found with osteoarthritis

Back 50

PIP - Bouchard's nodes. DIP - Herberden's nodes

Front 51

Joint space narrowing on x ray

Back 51

Osteoarthritis

Front 52

Acetaminophen reversibley inhibits COX and has analgesic effects but no

Back 52

anti inflammatory effects

Front 53

Pathogenesis of acetaminophen toxicity + antidote for toxicity

Back 53

NAPQI is a metabolite of the drug that depletes glutathoine - reacts with hepatocytes and can cause hepatic necrosis/liver failure. Antitode is N acetylcysteine, helps you regenerate glutathione

Front 54

Cox-2 inhibitor

Back 54

Celecoxib. Cox 2 is found in inflammatory cells and vascular endothelium. Cox 1 maintains gastric mucosa by making PGEs to protect it. So if you have someobdy with GI issues, give them COX-2 instead (less likely to cause peptic ulcer disease)

Front 55

NSAIDs reversibly inhibit COX 1 and 2, but aspirin IRREVERSIBLEY binds Cox 1

Back 55

remember that

Front 56

Pannus formation in MCP and PIP but NOT DIP

Back 56

Rheumatoid arthritis. Osteoarthritis affects the DIPs

Front 57

Ulnar deviation, subluxation of joints, rheumatoid nodules, baker cysts behind knees

Back 57

Rheumatoid arthritis

Front 58

Swann neck vs boutonnier deformities

Back 58

Found in late rheumatoid arthritis. Boutonniere - Flexion of PIP upwards and extension of DIP downwards (2) Swan neck - extention of PIP downwards, Flexion of DIP

Front 59

Which two antibodies can be found in people with rheumatoid arthritis?

Back 59

Rheumatoid factor (IgM antibody against IgG) and Anti CCP aka ACPA (anti citrullinated protein antibody).

Front 60

Prefered DMARD for patients with moderate/severe rheumatoid arthritis? What drug is this and what side effects does it have?

Back 60

Methotrexate - painful mouth ulcers and hepatoxicity, as well as increased susceptibility to infection b/c of bone marrow supression

Front 61

DMARDs - disease modifing antirheumatic drugs

Back 61

used to treat rheumatoid arthritis - methotrexate, hydroxychloroquine, sulfasalazine, TNF alpha inhibitors (etancercept/infliximab/adalimumab)

Front 62

This infection causes erythema infectiousum in children (facial rash/fever) and arthritis in adults. It can mimic rheumatoid arthritis but it is SELF RESOLVING usually

Back 62

Parvovirus B19

Front 63

Yellow is negative birereferingent - parallel to polarized light

Back 63

Gout

Front 64

How does drinking alcohol cause gout flare ups?

Back 64

Alcohol metabolites use the same excretion sites as uric acid in kidney. Because the kidney has to choose between excreting alcohol/uric acid, so uric acid builds up and you get gout

Front 65

How do you reat acute gout? Chronic gout?

Back 65

(1) Acute - NSAIDs mostly, or colchicine (stabalizes tubulin and inhibits polymerization of tubules to impair leukocyte chemotaxis --> Less inflammation) (2) Chronic - A) Allopurinol - inhibit xanthine oxidase to decrease uric acid synthesis. B) probenecid. inhibits uric acid reabsorption in PCT so it stays in urine and is excreted

Front 66

Monosodium urate crystals vs pyrophosphate crystals

Back 66

Gout, Pseudogout

Front 67

Needle shaped crystals vs rhomboid crystals

Back 67

Gout vs pseudogout

Front 68

Negative rheumatoid factor but strong HLA B27 association

Back 68

Seronegative spondyloarthropathies - psoriatic arthritis, ankylosing spondylitis, IBD, Reactive arthritis

Front 69

Sausage fingers (dactylitis) with psoriasis and arthritis

Back 69

Psoriatic arthritis

Front 70

Pencil in cup deformity of fingers on X ray

Back 70

psoriatic arthritis

Front 71

Sacroiliac joint and spine chronic inflammatory disease

Back 71

ankylosing spondylitis

Front 72

Fusion of spine aka Bamboo spine, improves with exercise

Back 72

ankylosing spondylitis

Front 73

Uveitis, sacroilitis, uveitis, aortic regurgitation and conduction abnormalities assoicated with

Back 73

ankylosing spondylitis

Front 74

Describe the respiratory, cardiovascular, and eye findings in ankylosing spondylitis

Back 74

Respiratory - ethesopathies (inflammation at tendon insertion site) is common with this disease, especially costovertebral/costosternal junction. This causes limited chest movement and results in hypoventilation. Cardiovascular - ascending aortitis leading to dilation and aortic insufficiency. Eye - uveitis

Front 75

Can't pee, can't see, can't climb a tree

Back 75

Reiter syndrome (aka reactive arthritis) - common after chlamydia or GI infections too - uveitis/conjunctivitis, urethritis, arthritis

Front 76

DMARDs can be used to treat seronegative spondyloarthropathies. One of these drug classes are TNF alpha inhibitors - what are these drugs?

Back 76

Entanercept, Infliximab, adalimumab, golimumab, certolizumab

Front 77

Risk associated with TNF alpha inhibitor use

Back 77

Reactivation of latent TB due to increased risk of infection/immune supression

Front 78

Persistent of joint swelling, synovial thickening and accumulation of synovial fluid affecting children younger than 10

Back 78

JIA - juvenile idiopathic arthritis

Front 79

What are the three types of Juvenile idopathic arthritis (JIA)

Back 79

Polyarticular - severe symmetrical arthritis, Pauciarticular - few large joints, Systemic onset - systemic systems THEN arthritis later

Front 80

Septic arthritis most commonly caused by these 3 organisms

Back 80

staph aureus, streptococcus, neisseria gonorrhoeae

Front 81

11 diagnostic criteria for lupus, need to have 4 of these at some point during course of disease to have lupus

Back 81

(1) Skin disorders - Malar (butterfly) rash on cheeks, discoid rash (seal has these on face), photosensitivity, painless oral ulcers. (2) Inflammatory disorders - non erosie arthritis in at least 2 joints, serositis (pleuritis or pericarditis), positive ANA (3) Organ system disorders - renal (proteinuria, cellular casts), neurological disorders, heme issues, immune - antiphosphlipid antibody, anti-dsDNA, antiSmith, false positive VDRL

Front 82

Antiphosphlipid antibody (aka anticardiolipin) anti dsDNA, anti Smith, false positive VDRL

Back 82

possible lab manifestations of lupus

Front 83

Leading cause of death of lupus patients - what is this and what does it look like on histo?

Back 83

lupus nephritis - "wire loop" appearance of kidney

Front 84

Anti histone antibodies associated with

Back 84

drug induced lupus

Front 85

Which drugs can cause lupus? What lab test would confirm drug induced lupus?

Back 85

SHIPP - Sulfanoamides, hydralazine, isoniazid, phenytoin, procainamide. Anti histone antibody. Associated with N-acetylation in the liver

Front 86

Fibrosis and excess collagen deposition throughout the body, skin gets tight and shiny without wrnickles

Back 86

scleroderma

Front 87

What are the two types of scleroderma?

Back 87

Diffuse and CREST syndrome

Front 88

Diffuse, widespread sclerosis that progresses rapidly and is associated with Anti DNA topoisomerase I (Anti SCL 70)

Back 88

Diffuse scleroderma

Front 89

What is CREST syndrome?

Back 89

Other type of scleroderma. C-calcinosis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangectasia

Front 90

Antibodies implicated with diffuse scleroderma vs CREST syndrome

Back 90

Anti topoisomerase I (Anti SCL 70) in diffuse, anti centromere antibodies with CREST syndrome

Front 91

Diffuse scleroderma vs CREST syndrome - which one is more rapid/severe? Which one involves skin more? which has more visceral organ involvement?

Back 91

Diffuse

Front 92

Dry mouth, dry mouth (trouble swallowing), and arthritis

Back 92

Sjogren's syndrome

Front 93

Can't see, can't spit, can't climb up sh*t

Back 93

Sjogren's syndrome

Front 94

Anti SSA (Anti Ro) and Anti SSB (anti La)

Back 94

Sjogren's syndrome

Front 95

X linked frameshift mutation causing dystrophin gene deletion

Back 95

Duchenne

Front 96

Accelerated muscle breakdown leading to elevated CK

Back 96

Duchenne

Front 97

Big calf muscles

Back 97

Duchenne

Front 98

Mutation of dystrophin gene

Back 98

Becker - less severe than duchenne

Front 99

Pain/stiffness in proximal joints (eg shoulder/hips) with malaise, weight loss, fever, associated with temporal arteritis

Back 99

PMR - polymyalgia rheumatica

Front 100

CD8 T cell induced injury to muscle fibers in shoulders/pelvis leading to proximal muscle weakness

Back 100

Polymyositis

Front 101

Anti Jo 1 and ANA

Back 101

Polymyositis

Front 102

Goutron's papules, helotrope rash on eyelids, shawl sign rash, mechanic's hands/feet possible with muscle weakness

Back 102

Dermatomyositis

Front 103

Excess muscle tenderness at particular sites, associated with stiffness, paresthesia, poor sleep, emotional disturbances

Back 103

Fibromyalgia

Front 104

Layers of epidermidis

Back 104

Californians like girls in string bikinis - Stratum corneum, lucidum, granulosum, spinosoum, basale

Front 105

E cadherin, actin associated with zonula adherens, these make ___ junction

Back 105

intermediate

Front 106

Macula adherens aka

Back 106

Desmosome - keratin involved here

Front 107

This connects the epithelial cell to basement membrane

Back 107

Hemidesmosome

Front 108

Desmosomes connect cells to each other, hemidesmosome connects

Back 108

Basememt membrane to epithelial cells

Front 109

Antibodies to hemidesmisome cause ____. Antibodies to desmosomes cause ____

Back 109

bullous pemphigoid, pemphigus vulgaris

Front 110

Atopic dermatitis aka eczema commonly found on ___ surfaces

Back 110

flexor

Front 111

Pruritic linear rash

Back 111

Contact dermititis aka poison ivy (or allergic to nickel on jeans for example)

Front 112

Treatment for acne address the hyperkeratosis, sbum overproduction, propionibacterium acnes proliferation, and inflammation

Back 112

(1) Retinoids (vitamin A analogs) eg tretinoin (2) Isotretinoin or spironolactone/estrogen (3) Erythromycin/clindamycin or benzoyl peroxide (4) Steroids if need really really quick reduction of inflammation

Front 113

Silvery scale rash, can also be associated with pitting of nails

Back 113

Psoriasis

Front 114

"parakeratotic scaling"

Back 114

Psoriasis

Front 115

Seborrheic keratosis found in

Back 115

OLDER patients - no risk of cancer

Front 116

Decreased melanin production in albinism due to tyrosinase enzyme issue (which normally catalyzes production of melanin from tyrosine)

Back 116

but you have normal number of melanocytes!

Front 117

Complete depigmentation of parts of the body

Back 117

vitiligo - decreased NUMBER of melanocytes

Front 118

Albinism vs vitiligo

Back 118

Albinism has normal melanocytes but less melanin, Vitiligo has DECREASED melanocytes

Front 119

Darkening of skin partches in pregnant women, or people taking OCPs or hormone replacement therapy

Back 119

melasma

Front 120

Infection of the dermis

Back 120

Cellulitis

Front 121

Exotoxin A of Staph aureus causing sloughing off skin

Back 121

Scalded Skin Syndrome

Front 122

Hairy leukoplakia on side of tongue caused by

Back 122

EBV in immunocompromised people

Front 123

Nikolsky's sign used to differentiate between

Back 123

Bullous pemphigoid and pemphigus vulgaris - in pemphigus vulgarius, you'll just rub someone's little mole thing and it'll fall off and that's positive. Negative in bullous pemphigoid

Front 124

Boulous pemphigoid and pemphigus vulgaris - which one has oral lesions

Back 124

Pemphigus vulgaris

Front 125

Pruritic rash associated with celiac's disease

Back 125

Dermatitis herpetiformis

Front 126

Erythema multiforme often caused by

Back 126

drugs (kinda mild steven johnson syndrome)

Front 127

Which drugs can cause steven johnson syndrome?

Back 127

Seizure meds, Sulfa meds, penicillins, allopurinol

Front 128

Severe form of Stevens johnson syndrome?

Back 128

TEN - toxic epidermal necrolysis

Front 129

Purple, plaques associated with hepatitis C

Back 129

Lichen Planus

Front 130

Pityriasis Rosea

Back 130

christmas tree rash

Front 131

Sandpaper like, premalignant lesion. Treat with 5 fluorouracil

Back 131

Actinic keratosis

Front 132

Most common skin cancers?

Back 132

Basal cell, then squamous, then melanoma

Front 133

Squamous cell carcinoma found on sun exposed areas especially hands and face

Back 133

just know that

Front 134

Keratin pearls, ulcerative red lesion

Back 134

Squamous cell carcinoma

Front 135

Rolled edge appearance with telangectasias

Back 135

Basal cell carcinoma

Front 136

S100 is a marker of this

Back 136

Melanoma

Front 137

Depth of tumor correlates with metastatic risk with

Back 137

Melanoma

Front 138

Use this SERM to treat osteoporosis and breast cancer

Back 138

Ralosifene - estrogen agonist in bone, estrogen antagonist in breast

Front 139

Osteomyelitis most commonly affects children - which part of bone does it affect mainly?

Back 139

metaphysis of long bones

Front 140

Treatment of myasthenia gravis?

Back 140

Pyridostigmine or neostigmine - cholinesterase inhibitors. Give scopolamine if you get muscaranic overstimulation (this is an antimuscarinic agent)

Front 141

When a muscle exerts too much force, the _____ inhibits muscle contraction and causes sudden muscle relaxation to prevent damage to musculoskeletal system

Back 141

Gogli tendon organs - sensory receptors located at junction of muscle/tendon

Front 142

Muscle spindle system is a feedback system that monitors and maintains muscle ___

Back 142

length

Front 143

Sunlight exposure catalyzes first reaction of active vitamin D synthesis

Back 143

7 dehydrocholesterol ---> cholecalciferol (aka Vitamin D3)

Front 144

What is caudal regression syndrome?

Back 144

Sacrala genesis causing lower extremity paralysis and urinary incontinence - associated with poorly controled maternal diabetes

Front 145

Subdural hematoma + bilateral retinal hemorrhages in an infant

Back 145

Shaken baby syndrome

Front 146

Common peroneal (aka fibular) nerve injury occurs with compression or trauma to lateral knee because it's superficially location. What motor/sensory dysfunction do you get with damage to this nerve?

Back 146

Superficial branch of the peroneal everts the foot and provides sensation to the majority of the dorsum of the foot. Deep peroneal nerve dorsiflexes the foot and provides sensation to the space between two first toes. Common peroneal nerve injury would cause foot drop and numbness to top of foot. It innervates the

Front 147

This nerve innervates flexors of arm (eg biceps) and provides sensory innervation to laterl forearm

Back 147

musculocutaneous nerve (medial forearm is ulnar)

Front 148

Lateral arm sensation and deltoid + teres minor innervation

Back 148

Axillary nerve

Front 149

Flattening of deltoid and loss of sensation following injury - what injury occured?

Back 149

Anterior dislocation of the shoulder (humerus) and damage to axillary nerve

Front 150

Upon release from sarcoplasmic reticulum, what does calcium bind to?

Back 150

Troponin C on thin filmenets. This shifts position of tropomyosin and exposes the myosin binding sites on the actin filaments.

Front 151

Where are the two common locations of ulnar nerve damage causing "claw hand" deformity?

Back 151

Either medial epicondyle of the humerus, or Guyon's canal near the hook of hamate and pisiform bone in the wrist

Front 152

What are the thick filaments in a sarcomere? Thin filaments?

Back 152

Thick - myosin. Thin is actin.

Front 153

Part of sarcomere with only thin actin filments? part of sarcomere that only has thick mysoin filaments

Back 153

I band (on either side of Z line). H band is the middle part of the A band (on either side of M line) that has only thick myosin filaments

Front 154

Which bone is commonly dislocated with falls?

Back 154

Lunate. It's smaller than the scaphoid on X ray. But these are the two bones that articulate with the radius

Front 155

What are the two bones that articulate with the radius?

Back 155

Scaphoid and lunar

Front 156

The sciatic nerve splits into these two nerves - name them and their function

Back 156

Tibial - goes in the popliteal fossa behind the knee. Involved with plantar flexion, toe flexion, and inversion of the foot (so damage means you'll be dorsiflexed and everted). Also provides sensation to PLANTAR foot Common peroneal lets you dorsiflex and sensation to the dorsum of the foot

Front 157

Psoas sign

Back 157

inflammation of psoas muscle causes pain when hip is extended.

Front 158

Which two muscles are major flexors of the hip?

Back 158

iliacus and psoas muscles

Front 159

Which nerve exits the plevis through the obturator foramen? This nerve supplies adductor muscles of the thigh and can be damaged during pelvic surgery

Back 159

Obturator

Front 160

Brachial plexus branching nerves from th lateral to medial cord?

Back 160

MARMU - Musculocutaneous, Axillary, Radial, Median, Ulnar

Front 161

The median nerve courses between the humeral and ulnar heads of the pronator teres muscle then runs between flexor digitorum superficialis/profundus muscles before entering wrist and hand within carpal tunnel

Back 161

just know that

Front 162

Myasthenia gravis patients have thymoma or thymic hyperplasia. The thymus and this arise from 3rd pharyngeal pouch

Back 162

inferior parathyroid glands. (superior parathyroid is from 4th pouch)

Front 163

"mosaic pattern of lamellar bone" with cement lines linking irregular sections of lamellar bone

Back 163

Paget's disease of the bone

Front 164

Muscles are made of two main fiber types - slow twitch (Type 1) and fast twitch (Type II) - what's the function of each? How do they differ in content of myoglobin and glycogen?

Back 164

Type I is low level, sustained force (like maintaining posture). They have high myoglobin concentration (example - paraspinal muscles). Type II are made for rapid forceful pulses of movement. They have very high glycogen content

Front 165

This ligament prevents posterior displacement of the tibia (leg) relative to the femur (thigh). Which ligament prevents anterior displacement of the tibia relative to the femur?

Back 165

PCL, ACL

Front 166

Injections in superomedial part of butt risk injury of ____. Injections in superromedial, inferomedial, and inferolateral regions risk injury to ____ nerve. The superolateral quadrant is relatively safe

Back 166

Superior gluteal nerve. Sciatic nerve

Front 167

Fracture of right humeral shaft can damage which artery?

Back 167

Deep brachial artery

Front 168

Osteoid matrix accumulation around trabeculae and bowing of legs

Back 168

Vitamin D deficiency - rickets or osteomalacia

Front 169

Uniform distribution of T tubules ensures ___

Back 169

coordinated contraction of all myofibrils

Front 170

Fetal bone growth retardation and discoloration of teeth if mom uses

Back 170

Tetracyclines -

Front 171

Femoral neck fractures can damage blood supply to femoral head and neck - which artery is damaged? This can cause avascular necrosis of femoral head

Back 171

Medial femoral circumflex

Front 172

Mastectomy can damage this nerve and cause winged scapuls

Back 172

Long thoracic nerve

Front 173

Why does low estrogen cause osteoblasts?

Back 173

Increased/overexpression of RANK receptors causes incrased bone resorption because of increased osteoclastic activity

Front 174

Half of all patients with lambert eaton also have

Back 174

small cell lung cancer

Front 175

Pathogenesis of lambert eaton myasthenic syndrome

Back 175

Antibodies against voltage gated calcium channels participating in acetylcholine release

Front 176

Proximal muscle weakness, cranial nerve involvement (diplopia, ptosis, dysarthria/dysphagia), and autonomic signs with possible small cell lung cancer

Back 176

Lambert Eaton

Front 177

Sudden traction on outstretched/pronated arm of a child (eg, kid falls while holding hands with someone) can cause this injury

Back 177

Annular ligament tear and displaced. Radial head is subluxed. Pain when moving elbow

Front 178

Sudden upward stretching of the arm (e.g.: falling off a tree and catching a branch) could produce this damage

Back 178

Lower trunk brachial plexus damage (C8, T1)

-Median & ulnar nerves are damaged --> intrinsic muscles of the hand dysfunction --> hand clumsiness

Front 179

Serum marker for osteoBLAST activity

Back 179

ALK P (bone specific)

Front 180

Serum marker for osteoCLAST activity

Back 180

Tartrate-resistant acid phosphatase

urinary hydroxyproline

Urinary deoxpyridinoline

Front 181

What skin changes are associated w/ aging?

Back 181

-Reduced elasticity

-Thinning of dermis, epidermis

-Flattening of the dermoepidermal junction

-Decreased # of fibroblasts

Front 182

How does hyperparathyroidism affect the bone?

Back 182

Causes subperiosteal resorption w/ cystic degeneration

Front 183

What effect does anbolic steroid misuse have on the development of acne?

Back 183

Androgen stimulation of follicular epidermal hyper proliferation & excessive sebum production

Front 184

Diseases associated w/ erythema nodosum?

Back 184

Sarcoidosis

Crohn's Disease

Others

Front 185

What's the order of skin changes you see in Pityriasis Rosea?

Back 185

1. Herald patch

2. Christmas tree distribution

Front 186

What is the hallmark of necrotizing fasciitis?

Back 186

Tenderness expressed beyond the area of cellulitis

-Can also sometimes feel crepitus -- from the methane/CO2 production fro causal bacteria

Front 187

Are hairy leukoplakia or leukoplakia pre-cancerous?

Back 187

5-25% of Leukoplakia are precancerous

Hairy leukoplkia is NOT precancerous

Front 188

How do we differentiate between hairy leukoplakia or oral candidiasis (thrush) if we're unsure?

Back 188

Hairy leukoplakia can't be scraped off

Front 189

What pattern does a punch biopsy of a pemphigus vulgaris lesion show?

Back 189

Reticular pattern on IF

Front 190

Microscopically, what do we see in Pemphigus Vulgaris?

Back 190

Acantholysis -- loss of intercellular connections (b/c of desmosome mutation)

Front 191

Which skin cancer has the greatest metastatic risk?

Back 191

Melanoma

Front 192

What are the ABCDs of melanoma?

Back 192

Asymmetry

Border irregularity

Color

Diameter

Front 193

What layer of the epidermis are melanocytes found?

Back 193

Stratum basale (bottom layer)

Front 194

What is perakeratosis? What skin disease is it seen in?

Back 194

Maintenance of nuclei in the stratum corneum -- seen in Psoriasis

Front 195

Which muscles are responsible for hip flexion?

Back 195

Iliopsoas

Rectus femoris

Tensor fascia lata

Front 196

Which muscles are responsible for hip extension?

Back 196

Gluteus maximus

Biceps femoris

Front 197

Which muscles are responsible for hip ABduction?

Back 197

Gluteus minimus, medius

Front 198

Which muscles are responsible for hip ADduction?

Back 198

Adductor brevis

Adductor longus

Adductor magnus

Front 199

What distinction is made via the lepromin skin test?

Back 199

Tuberculoid leprosy (mild, Th1 response) = +

Lepromatous leprosy (severe, Th2 response) = -