Mss-Dr. Leech Lectures Review

Front 1

OA vs. RA: which is symmetrical and which is asymmetrical? Which is autoimmune and which is wear-and-tear related?

Back 1

OA: wear and tear, asymmetrical
RA: autoimmune, symmetrical

Front 2

What is the most common form of arthritis?

Back 2

OA

Front 3

OA vs. RA: which affects large weight bearing joints? Which affects smaller joints?

Back 3

OA: large joints (knees, hips, spine)
RA: small joints (hands and feet)

Front 4

T or F: OA risk increases with age.

Back 4

true

Front 5

OA vs. RA: which produces synovial proliferation?

Back 5

RA

Front 6

How would x-rays differ in OA and RA?

Back 6

OA: narrowed joint space
RA: juxta-articular osteoporosis and bone erosions; joint effusion

Front 7

RA or OA: which shows morning stiffness that improves throughout the day?

Back 7

RA

Front 8

What are some systemic symptoms of RA?

Back 8

fever, malaise, fatigue, lymphadenopathy, rheumatoid nodules, Sjogren’s syndrome, amyloidosis

Front 9

Synovitis, pannus formation, fibrous and bony ankylosis, joint deformities, and baker cysts are all symptoms of OA or RA?

Back 9

RA

Front 10

What is eburnation? Is this seen in OA or RA?

Back 10

exposed bone becomes polished; OA

Front 11

A systemic, chronic inflammatory disease characterized by progressive arthritis, production of rheumatoid factor, and extra-articular manifestations:

Back 11

RA

Front 12

OA or RA: subchondral bone sclerosis and cysts, loose bodies, bone spurs.

Back 12

OA

Front 13

OA or RA: affects females 20-50

Back 13

RA

Front 14

What are the possible genetic causes for RA?

Back 14

HLA-DR4 and DR1

Front 15

OA or RA: which is associated with "loose bodies" and osteophytes (bone spurs)?

Back 15

OA

Front 16

What is the term for arthritis due to infection? Which bacterium is most often associated with this kind of arthritis?

Back 16

suppurative arthritis; gonococci, staph, strep

Front 17

Where are rheumatoid nodules normally found?

Back 17

extensor surfaces of forearms or elbows

Front 18

Which form of arthritis usually displays large, tender, painful, swollen erythematous joints, and is monoarticular?

Back 18

suppurative arthritis

Front 19

In which arthritis will there be cloudy synovial fluid with high neutrophil count?

Back 19

suppurative arthritis

Front 20

What are the features of a ganglionic cyst?

Back 20

1. up to 1.5cm
2. in joint capsule or tendon sheath
3. benign
4. no communication with joint space
5. likely recurrence

Front 21

What is the most common MD?

Back 21

Duchenne's

Front 22

What is lacking in Duchenne's MD?

Back 22

dystrophin
(hint: Duchenne's-Dystrophin-Disastrous)

Front 23

What is the problem in Becker's MD?

Back 23

dystrophin size is altered

Front 24

Which MD has a slower progression and is more delayed: Becker's or Duchenne's?

Back 24

Becker's

Front 25

What gene is affected in X-linked MD? Which protein does this encode?

Back 25

Xp21 gene; encodes a 427kd protein

Front 26

Which MD has the following histopathology: variation in fiber size, increased number of internalized nuclei, degeneration of muscle fibers, regeneration of muscle fibers, and proliferation of endomysial connective tissue?

Back 26

x-linked MD

Front 27

Which MD is normal at birth, but begins to weaken by 5 y/o with death by early 20’s?

Back 27

x-linked MD

Front 28

Which ion channel myopathy shows the following: autosomal dominance, hypermetabolic state triggered by anesthesia, (halogens and succinylcholine), and mutation in sodium channels?

Back 28

malignant hyperpyrexia (malignant hyperthermia)

Front 29

What is Lambert-Eaton (LE) myasthenic syndrome? What is this commonly associated with?

Back 29

paraneoplastic disorder of the NMJ; small cell carcinoma of the lung

Front 30

MG or LE: which has increased contractions with repeated stimuli?

Back 30

Lambert-Eaton (LE)

Front 31

What disease presents with easy fatigability, ptosis, thymoma, and diplopia resulting from immune mediated injury?

Back 31

MG

Front 32

Antibodies are formed against what in MG?

Back 32

Ach receptors

Front 33

What is the treatment in MG?

Back 33

plasmapheresis; removing thymomas

Front 34

What is the most common form of inherited dwarfism?

Back 34

achondroplasia

Front 35

What is the inheritance pattern seen in achondroplasia?

Back 35

autosomal dominant

Front 36

Where is the mutation in achondroplasia? What does this do?

Back 36

mutation in fibroblast growth factor receptor 3 (FGFR3)->inhibited cartilage synthesis at epiphyseal growth plate, decreased endochondral bone formation and premature ossification of the growth plates

Front 37

Describe the bone structure in achondroplasia:

Back 37

long bones are short and thick, cranium and vertebrae are normal

Front 38

Briefly describe osteogenesis imperfecta (OI):

Back 38

hereditary defect that causes abnormal synthesis of type I collagen, leading to brittle bones

Front 39

What disease will display the following features: recurrent fractures, blue sclera, deafness, and hypermobility?

Back 39

OI

Front 40

Of the 4 types of osteogenesis imperfecta, which form is the most lethal?

Back 40

type II (causes stillbirth)

Front 41

Name the disease: localized disorder of bone remodeling resulting in excessive bone resorption followed by disorganized bone replacement, producing thick but weak bone that is susceptible to deformity and fracture.

Back 41

Paget's disease

Front 42

Describe the pattern seen in Paget's disease:

Back 42

Triphasic Pattern: osteolytic, mixed osteolytic-osteoblastic, osteosclerotic

Front 43

What population does Paget's disease mostly affect?

Back 43

those of European descent over 40 y/o

Front 44

What is the most common bone disease in the U.S.? Who does it target?

Back 44

osteoporosis; postmenopausal women and elderly

Front 45

Name the disease: decreased bone mass (ostopenia) resulting in thin fragile bones that are susceptible to fracture.

Back 45

osteoporosis

Front 46

What are the 2 forms of osteomyelitis?

Back 46

pyogenic and tuberculous

Front 47

What is the most common spread of pyogenic osteomyelitis?

Back 47

hematogenous (seeding of bone after infection)

Front 48

What bacteria are indicated in pyogenic osteomyelitis?

Back 48

Staph aureus, E coli, Streptococci, Gonococci, Haemophilus influenzae, Salmonella, Pseudomonas

Front 49

What are the clinical signs in pyogenic osteomyelitis?

Back 49

fever and leukocytosis, localized pain, erythema, and swelling

Front 50

What is the treatment for pyogenic osteomyeltis?

Back 50

antibiotics and surgical drainage

Front 51

Name the disease based on this characteristic: caseating granulomas with extensive destruction of the bones.

Back 51

tuberculous osteomyelitis

Front 52

What are the common sites for tuberculous osteomyelitis?

Back 52

thoracic and lumbar vertebrae (“Pott disease”)

Front 53

Tuberculous osteomyelitis is seen in what % of TB cases?

Back 53

1%

Front 54

What is the most common bone lesion?

Back 54

metastatic cancer (prostate, breast, lung, thyroid, kidney)

Front 55

Name the disease: malignant neoplasm of undifferentiated cells arising in marrow cavity.

Back 55

Ewing's Sarcoma

Front 56

Describe the genetics of Ewing's sarcoma:

Back 56

classic translocation t(11;22) which produces EWS-FLI1 fusion protein

Front 57

What populations are affected most by Ewing's sarcoma?

Back 57

males more than females, teenagers

Front 58

What is the most common soft tissue tumor of adulthood?

Back 58

lipoma

Front 59

What does a lipoma (fatty tumor) consist of?

Back 59

mature fat cells and delicate reticulin network with a surrounding capsule

Front 60

Where are lipomas normally found on the body? What populations?

Back 60

trunk or upper extremities in the subcutaneous region; middle-aged and elderly men and women

Front 61

What is the treatment for lipoma?

Back 61

excision

Front 62

What is one of the most common sarcomas of adulthood? What populations are seen?

Back 62

liposarcoma; 40's-60's

Front 63

Where are liposarcomas found?

Back 63

deep soft tissues of proximal extremities and retroperitoneum

Front 64

What are some microscopic findings in a liposarcoma?

Back 64

well-differentiated, myxoid, round cell and pleomorphic variants; lipoblasts with small lipid vacuoles

Front 65

What is the most common type of soft tissue sarcoma? Which of these is most common?

Back 65

malignant fibrous histiocytoma (MFH); Storiform-pleomorphic

Front 66

What are some microscopic findings in an MFH?

Back 66

swirling (storiform) pattern, plump spindle cells

Front 67

Where are MFH normally found? What population?

Back 67

deep soft tissues of extremities; peak in 7th decade

Front 68

Name the disease: presence of metaplastic bone in soft tissue (musculature); usually in athletic adults/young adults following trauma.

Back 68

Myositis Ossificans

Front 69

How can Myositis Ossificans be differentiated from a neoplasm?

Back 69

in MO, bone matures peripherally, not centrally

Front 70

How can MO be treated?

Back 70

excision

Front 71

Is this early or late MO: circumscribed, full → painless, hard, well-demarcated?

Back 71

late

Front 72

What skin lesion is a benign, round, brownish purple growth with an unknown etiology?

Back 72

dermatofibroma

Front 73

Which type of OI shows little progression after puberty?

Back 73

type I

Front 74

X-ray findings in osteopetrosis?

Back 74

Erlenmeyer flask”-shaped deformity

Front 75

Paget's disease would show elevation of what lab test?

Back 75

alk phos

Front 76

T or F: Paget's disease can have cardiac sequelae?

Back 76

true

Front 77

What is the most common organism in osteomyelitis?

Back 77

s. aureus