Musculoskeletal

Front 1

5 year old boy, musculear weakness,cant keep up with peers. Serum creatine kinase is elevated. what lab test finding would be appropriate for diagnosis

Back 1

kid has duchene muscular dystrophy. Use an immunohistochemical stain for dystrophin to confirm absence of dystrophin.

Front 2

25yo female experiencing episodes of nubness and tingling in her right and left hands for several months. makes it difficult to use the computer keyboard. The thumb and first two fingers are most affected. no pain or swelling and no hx of trauma to her upper extremities. what is the most likely cause

Back 2

repetitive stress...she is experiencing carpal tunnel syndrome, a form of compression neuropathy, resulting from the entrapment of the median nerve beneath the flexor reticulum at the wrist.

Front 3

63yo man, on hemodialysis for chronic renal failure, has decreased sensation in lower extremeties, but no decrease in strength or gait...most likely cause:

Back 3

He's experiencing a predominantly sensory peripheral neuropathy in diabetes mellitus

Front 4

17yo male with generalized muscle pain with fever for past wk. Develops increasing muscle weakness and diarrhea over past 2 days. Labs suggests eosinophilia...what conidition most he likely have?

Back 4

Muscle pain with fever and eosinophilia suggests a parasitic infection, most likely Trichinosis (from poorly cooked infected meat).

Front 5

35 yo man, increasing weakness of pelvic and shoulder girdle over years' time. Western blot of affected muscle=low dystrophin with abnormal molecular weight...what condition?

Back 5

Becker Muscular Dystrophy ...similar to Duchenne muscular dystropy (both X-linked with mutaion in dystrophin gene) but differ in that DMD has no dystrophin and BMD has dystrophin, but is abnormal.

Front 6

chest XR of 40 yo asymptomatic male reveals focal small calcifications in teh diaphragmatic leaves...what is the condition?

Back 6

Trichinosis...caused by ingestion of un/poorly cooked meat contaminated with Trichinella spiralis and cases are mostly asymptomatic, but clue to past infection is the appearance of the calcified encysted organisms in muscle with the diaphragm and other most active muscle are prefered

Front 7

56yo, with Sjogren syndrome, presents with double vision and eyelid drooping, particularly towards the end of the day. Difficulaty chewing food at dinner. Symptoms have persisted over past month...what is most likely lab test finding?

Back 7

He has Myesthania gravis caused by antibody-mediated loss of acetylcholine receptors at the neuromuscular jxn.

Front 8

72 yo male with weight loss along with proximal muscular weakness and diff with urination over several months, AntiACHase agents produced no clinical improvement, no antiACH-receptro Ab's...what is the condition

Back 8

Lambert Eaton myasthenic syndrome...most often assoc. with small cell carcinoma of the lung!

Front 9

56yo female with increasing generalized weakness for past 2 months. has 3/5 muscle strength in upper and lower extrems. no fever and bp is 155/90. shows type II muscle atrophy of gastrocnemius...what is the condition.

Back 9

Cushing's syndrome...excess glucocorticoids and prolonged immoblization presents with type II atrophy

Front 10

44yo male, worsening CHF, with muscular weakness involving upper arms and legs. Deltoid biopsy shows reduced dystrophin...he has

Back 10

becker muscular dystrophy

Front 11

40yo male, influenza like illness, ascending motor weakness, lymphocytic infiltrates in peripheral nerves, and segmental demyelination suggests

Back 11

Guillain-Barre syndrome

Front 12

35yo female, muscular weakness, eyes droop, double vision. problems get progressively worse in teh day...what will lab show?

Back 12

increases serum level of Ach-receptor AntiB's...aka myasthenia gravis

Front 13

55yo male, shallow nonhealing ulceration on medial malleolus, distal symmetric decreased sensation in his lower extremities; Hx of mutlple UTI's, impotent...finding in peripheral nerves?

Back 13

Axonaly neuropathy...related to diabetes mellitus

Front 14

42yo male, increasing progresive muscular weakness bot arms and legs for 2years, group atrophy on quad biopsy...what is condition

Back 14

Lou Geherigs disease/Amyotrophic lateral sclerosis (ALS)...denervation type muscular atrophy, b/c individual neuron innervates a group of muscle fibers.

Front 15

pain in right eye, slit-lamp examination with fluorescein dye reeals a dendritic ulcer on right cornea....probably cause

Back 15

Herpes Simplex (most common cause of corneal ulcers)

Front 16

31yo male, increasing diff seein at night but not day; years later , daytime vision decreases. Funduscopic exam=branching reticlated pattern to the retina, waxy-appearing optic disc, and attentuation of retinal blood...suggest:

Back 16

Retinitis pigmentosa

Front 17

newborn with unilateral retinoblastoma. Molec. analysis of enucleated tumor cells=loss of both Rb gene alleles. norml Rb locus in skin fibroblasts...what is true

Back 17

both copies of Rb gene were lost b/c of mutations in retinoblasts.

Front 18

63yo woman, type I diabetic since 18yo, has had increaseing diff with vision for past decade. which of path findings is likely

Back 18

Capillary microaneurysms...common presenting clinical sign with background iabetic retinopathy

Front 19

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Back 19

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Front 20

50yo male, penetrating injury to left eye with plywood, partial uveal prolapse results, still has vision. 3wks later=loss of accommodation, photophobia, and blurred vision in his right eye, and choroidal infiltrates seen on funduscopic exam...diagnosis is.

Back 20

sympathetic opthalmia that results from an antigen rleased from one eye causing inflammatory rxn in the other eye...remove traumatized eye to avoid complication

Front 21

3yo boy, mass on left eye is most likely..

Back 21

Retinoblastoma...most common malignant ocular neoplasm of childhood.

Front 22

62yo female, decreasing vision, funduscopic exam=deepening of ectopic cup with excvaiton...causative disease:

Back 22

Glaucoma...detected by increased ocular pressure that causes loss of nerve fiers, resulting in a characteristic cupped excavation of optic disc.

Front 23

5yo child, mental retardation, Brushfield spots (speckled irides from ringlike foci of iris hypoplasia surrounding relatively normal iris stroma) on eyes; Hypertelorismis present. child is most likely...

Back 23

Trisomy 21 (Down Syndrome)..present with varity of ocular abnormalities

Front 24

6yo child, decreased vision, diffuse punctat inflam of cornea, pannus extending as a growth of fibrovascular tissue from conjunctiva on to the cornea; lymphocytes, plasma cells, and neutrophils along corneal epithelial cells with cytoplasmic inclusion bodies.infectious agent is..

Back 24

Trachoma...one of the world's major causes of blindess.

Front 25

fundoscomic ecam of 68yo male= arteroiolar narrowing, flame-shaped hemorhages, cotton-wool spots, and hard, waxy exudates...sugesting

Back 25

hypertensive retinopathy from long-standing hypertension, with progressive changes that begin with generalized narrowing of the arterioles

Front 26

30 yo male, severely impaired vision in botheyes., brother is similar, but parents are noraml. exam= diffuse cloudiness of the anterior stroma, aggregates of gray-white opacicorneal transplantation, and basophilic deposits in the stroma, postive for acid mucopolysaccharides...diagnosis is

Back 26

Maculary Dystrophy...autosomal dominant and themost severe inherited corneal stromal dystorpny

Front 27

microaneurysms in the retinal vesses are seen in...

Back 27

pple with Diabetes Mellitus

Front 28

8yo child, marked decreased visual acuity as a consequence of keratomalacia; severe keratinization of all mucous membrane epithelia, including cornea and conjunctiva, and has xerophthalmia...all due to..

Back 28

Keratomalacia and xerophthalmia are characteristic vitamin A deficiency

Front 29

70yo, sudden loss of upper half of visual field in right eye. Before, he had decrease in visual acuity in both eyes for past few years. fasting serum glucose 165mg/dL. Is obese...what is the pathological process

Back 29

Retinal detachment due to Retinitis proliferans of late stage proliferative retinopathy of diabetes mellitus

Front 30

32wk premature baby requires intubation and postive pressure ventilation with 100% o2 to treat hyaline membrane disease. Survived and discharged, but later is not visually responsive...baby has..

Back 30

Retrolental fibroplasia from 02 toxicity to the immature retinal vasculature, leading to neovascularization of the retina with ingrowth into the vitrous

Front 31

76 yo woman, decreasing vision of central pattern, both eyes. Funduscopic exam = retianl pigment epithelium atrophic and depigmented...condition is

Back 31

Macular degeneration..most often an age-related condition, and most common cause of decrease vision in elderly.

Front 32

long-term high dose glucocorticoid therapy is required for a patient with systemic LES, with severe lupus nephritis...most likely will lead to..

Back 32

Cataracts of crystalline lens..due to systemic therapy with glucocorticoids. but can also be caused by DM, aging, glaucoma, UV or irradiation.

Front 33

retinal detachment is most likely complication of..

Back 33

Diabetic retinopathy

Front 34

78yo wmn, increasing diff vision, worst at night. cloudiness and opication limit direct vision, i.e cant read printed material. visionis better in periphery..what is patho process occured

Back 34

nuclear sclerosis of the lens giving rise to cataracts in aging pple.

Front 35

54yo male, decrease in visual acuity on right. 15mm choroidal mass is observed, week later patient is blind in right eye "as though windo shade is pulled downn 1/2 way" condition...

Back 35

Uveal melanomas ivolving the choroid, the iris, or the ciliary body. often pigmented and may cause retinal detachment