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85 Cards in this Set
- Front
- Back
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What is seen in muscles without T-tubules?
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uncoordinated contraction of myofibrils
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What is seen with myasthenia gravis?
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Poor force generation with repeated stimulation
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What is seen with myotonic dystrophy?
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Impaired relaxation after single contraction. Autosomal dominant. Due to myotonin protein kinase defect.
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What is Reiter's syndrome?
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Urethritis, conjunctivitis, arthritis following infection from chlamydia, salmonella, shigella, campylobacter jejuni, Yersinia.
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What does Colchicine do? Side effects?
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Disrupts microtubule formation. For ACUTE gout. Can cause diarrhea and nausea vomiting.
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How are osteocytes connected?
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gap junctions
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Process for collagen formation?
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Start with alpha chains in cytoplasm. Move to RER. Then hydroxylate lysine and prolines. Then glycosylation of selected lysine residues. Assembly into triple helix. After, goes to golgi. Extruded into ECM. Then N and C terminal propeptide cleavage by propeptidase (procollagen --> collagen). Collagen fibrils.
Then covalent cross links formed by lysyl oxidase. |
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What are is in the first pharyngeal pouch? Groove? Membrane?
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Pouch - epithelium of middle ear and auditory tube
Membrane - tympanic membrane Groove - epithelium of external ear canal |
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What is in the 2nd pharyngeal pouch?
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Palatine tonsil crypts
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What is in the 3rd pharyngeal pouch?
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Thymus, inferior parathyroid
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What is in the 4th pharyngeal pouch?
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Superior parathyroid gland, ultimobranchial body
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What does low estrogen due to bone?
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Increases resorption by increasing RANK on osteoclasts.
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What does PTH do to bone? How?
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Increases resorption by increasing monocyte colony stimulating factor and RANKL on osteoblasts to make more mature osteoclasts
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Joints affected by Osteoarthritis?
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DIP - Heberden's nodes
PIP - Bouchard's nodes |
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Joints affected by Rheumatoid Arthritis?
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MCP and PIP
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What will happen with too much Vitamin D?
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Normal system should be shunted to tachysterol and lumisterol to avoid too much
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Pathway again for Vit D formation?
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7-dehydrocholecalciferol
SKIN Cholecalciferol LIVER 25 KIDNEY 1,25 |
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What is Ehlers-Danlos a defect in?
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Collagen
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What are hypopigmented skin patches on tan skin suggestive of? treatment?
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Pityriasis versicolor from Malassezia furfur. Called spaghetti and meatballs.
Rx: Topical antifungal or selenium containing shampoo |
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Pathogenesis for Rheumatoid Arthritis? What is RF?
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CD4 T helper - activated by cartilage. Activate B cells. Make RF - which are IgM for Fc of self IgG.
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What disease has anti-centromere?
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CREST
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What disease has anti-dsDNA?
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SLE specific
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What disease has anti-Scl-70 antibody (anti-DNA topoisomerase I antibody)?
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Diffuse scleroderma
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What is koilonychia suggestive of?
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Spoon nails. Fe deficiency anemia.
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When do you see clubbing?
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Hypoxia - large cell lung cancer, TB, CF, bronchiectasis
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What are gout crystals made of?
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Monosodium urate
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Where are calcium oxalate found?
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Renal calculi
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Where is Calcium hydroxyapatite found?
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Calcific tendonitis
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What is the crystal of Calcium pyrophosphate?
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Psuedogout
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Treatments for Rheumatoid Arthritis?
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Early and rapid = steroids
Immunomodulators for early seronegative = sulfasalazine, hydrocychloroquine, minocycline D-Mard - Methotrexate |
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What are the gout treatments?
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Early - NSAIDs and Colchicine
Late - Allopurinol Uricosurics if ok kidneys - Probenecid or sulfinpyrazone |
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What is characteristic of Paget's disease of bone?
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Older, bone pain, and elevated alkaline phosphatase
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What is pathogenesis of Paget's disease of bone?
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Mosaic bone pattern from increase osteoclastic activity leading to osteoblast activity. Increased blood flow from increased AV shunts leading to heart failure.
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What is alkaptonuria?
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Defective homogentistic acid oxidase. Leads to pigment deposits in sclera, ears, arthritis. Urine turns black left standing in open.
Part of degradation of tyrosine pathway. Takes homogentisate to Maleylacetoacetate. |
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What artery serves epiphyseal plate for femur?
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obturator
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What artery provides the majority of the blood supply to the femoral head and neck?
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Medial femoral circumflex
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Two signals for osteoclast differentiation?
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RANK-L and M-CSF
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Signs for Paget's disease of bone?
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systemic bone resorption, increased nuclei of osteoclasts
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Most common cause of hair loss in men and women?
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AD. Androgenetic alopecia.
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Blocked femoral nerve would see?
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No knee jerk
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Blocked tibial would see no?
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Plantar flexion
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Blocked lateral sural cutaneous would see?
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No sensation to calf
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Blocked common peroneal would see?
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foot drop
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What covers sesnation of anterior dorsum of foot?
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Superficial peroneal
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Biggest risk factor for osteoarthritis?
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Age
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Not using muscle on bx?
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Decreasing myofibrils
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Axillary lymph node surgery can injure what?
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Long thoracic nerve (serratus anterior)
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Anterior dislocations of knee can damage what?
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Popliteal artery. (near adductor magnus/soleus muscles)
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Lymph node from foot above?
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Popliteal fossa
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How is force transmitted from radius to ulna?
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Interosseus membrane
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Strengthen what for urinary continence?
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Urogenital diaphragm
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what node is sensitive to abdominal cancers?
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virchow's (supraclavicular) Left side!!!!
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What things increase muscle velocity?
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Decreased preload, increase preload, increased passive tension
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Unhappy triad?
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Medial collateral ligament, ACL, Lateral meniscus
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What artery travels with radial nerve?
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Deep brachial
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When can deep brachial artery get injured?
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Humeral shaft fracture
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Injury to brachial artery?
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Supracondylar fracture to humerus
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Being on knees all day affects?
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Prepatellar bursa
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Osteopetrosis mechanism?
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Failed bone resorption. Get anemia, thrombocytopenia, infection from decreased marrow space.
From genetic deficiency in carbonic anhydrase II can impinge on Cranial Nerves |
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Osteitis fibrosa cystica is?
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Increased PTH. Get brown tumors. High ALP.
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Paget's disease serum sign?
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High ALP.
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Most common benign bone tumor?
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Osteochonodroma
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Ewing's description sarcoma?
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Most common young boys. 11,22 translocation. Onion skin appearing.
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Pemphigus vulgaris?
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Ig against desmosomes. Involves oral mucosa. Positive nikolky's sign and separation of epidermis with stroking of skin.
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Bullous pemphigoid?
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IgG against hemidesemosomes. Below the epidermis on BM. Eosinophils inside. No mucosal involvement.
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Squamous cell carcioma?
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ulcerative red lesion, keratin pearls
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Basal cell carcinoma?
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Pearly papules, telangectasias. Palisading nuclei.
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Polyarteritis nodosa?
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Have Hep B. Not pulmonary arteries.
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Testicular sheaths and origin?
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Testes
Tunica vaginalis = peritoneum Internal spermatic fascia = transversalis fascia Cremaster = internal oblique External speratic = ext oblique |
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Duchenne MD on bx?
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fatty replacement
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Prolonged sound to Organ of Corti?
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shears against tectorial membrane
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What test can lupus anticoagulant make positive?
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VDRL
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Distinguishing hernias?
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Direct is medial to inferior epigastric.
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What causes pitting breasts/ peau d'orange?
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Obstructed lymphatics
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What vibrates against stapes?
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Oval window. Scala vestibuli on top. Basilar membrane with cilia and high K. Helicotrema at the other end.
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Gallstones get stuck where?
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Ileum
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Muscle, Ca, troponin?
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Calcium enters from CA release from SR ryanodine receptor. Ca binds troponin C, shiftin tropmyosin, exposing myosin binding sites on actin filament. Ca-ATPase from SR terminates Ca influx.
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Cause of claudication?
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Atherosclerosis
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Monckebergs?
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Medial calcinosis. Older people. Clinically asymptomatic, not narrowing lumen.
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Granulomatous inflammation characterizes of media?
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Temporal arteritis
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Chest expansion can decrease with ankylosing spondylitis?
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Yes.
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Other features of ankylosing spondyltitis?
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uveitis, ascending aortitis
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Sarcoid presentation?
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Young black female. With bilateral hilar issues. Leads to pulm fibrosis. Also shin nodules.
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Femoral hernia?
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Below inguinal hernia. Lateral is femoral vein. Prone to incarceration and strangulation.
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Close to inferior thyroid artery?
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Recurrent laryngeal nerve
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