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203 Cards in this Set

  • Front
  • Back
What makes up the unhappy triad in a knee injury?
Damage to ACL, MCL & medial meniscus
Caused by clipping from the lateral side
What are the rotator cuff muscles?
SITS
Supraspinatus, Infraspinatus, Teres minor, Subscapularis
Failure of longitudinal bone growth leads to short limbs
Achondroplasia
Heberden's & Bouchard's nodes
Heberdon's-DIP; Bouchard's-PIP
a/w osteoarthritis
Failure of normal bone resorption leads to thickened, dense bones
Osteopetrosis
"Brown tumors"
a/w Osteitis fibrosa cystica- caused by hyperparathyroidism
Abnormal bone architecture caused by increase in both osteoblastic & osteoclastic activity
Paget's disease of the bone
Bone is replaced by fibroblasts, collagen & irregular bony trabeculae
Polyostotic fibrous dysplasia
Joint problem a/w temporal arteritis
Polymyalgia rheumatica
Progressive symmetric proximal muscle weakness caused by CD8+ T-cell-induced injury to myofibers
Polymyositis
Polymyositis w/ "shawl & face" skin rash & increased risk of malignancy
Dermatomyositis
Antibodies to U1RNP
Mixed connective tissue disease
Dry eyes, dry mouth & arthritis
Sjogren's syndrome
a/w rheumatoid arthritis & dental carries
Sjogren's syndrome
Autoantibodies to SS-A(Ro) & SS-B(La)
Sjogren's syndrome
Monosodium urate crystals
Gout
Calcium pyrophosphate crystals
Pseudogout
a/w elevated levels of ACE
Sarcoidosis
Joint problem a/w uveitis & aortic regurgitation
Ankylosing spondylitis
Triad of: Urethritis, Conjunctivitis & anterior uveitis, Arthritis
Reiter's syndrome
"Can't see, can't pee, can't climb a tree"
What is CREST syndrome
Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly & Telangiectasia
Dysplastic nevus is a precursor to what?
Melanoma
Most common benign bone tumor
Osteochondroma
Bone tumor w/ interlacing trabeculae of woven bone surrounded by osteoblasts; <2cm
Osteoid osteoma
Bone tumor w/ interlacing trabeculae of woven bone surrounded by osteoblasts; >2cm
Osteoblastoma
Bone tumor w/ "double bubble" or "soap bubble" appearance on x-ray
Giant cell tumor
Bone tumor that is a cartilaginous neoplasm found in intramedullary bone of distal extremities
Enchondroma
Most common primary malignant tumor of bone
Multiple myeloma or Osteosarcoma depending on the source
Bone tumor w/ Codman's triangle on x-ray
Osteosarcoma
Bone tumor w/ anaplastic small blue cells
Ewing's sarcoma
Bone tumor w/ "Onion skin" appearance in bone
Ewing's sarcoma
Bone tumor a/w t(11;22)
Ewing's sarcoma
Malignant cartilaginous bone tumor
Chondrosarcoma
Expansile glistening mass within the medullary cavity
Chondrosarcoma
Bone tumor w/ peak incidence of 20-40 years old
Giant cell tumor
Bone tumor that is most common in men <25 years old
Osteochondroma
Bone tumor w/ peak incidence in men of 10-20 years old
Osteosarcoma
Tumor caused by t(x;18)
Synovial sarcoma
Bone tumor that is most common in boys <15 years old
Ewing's sarcoma
Bone tumor that is most common in men 30-60 years old
Chondrosarcoma
Vasculitis seen commonly in heavy smokers
Beurger's disease
Vasculitis known as "pulesless disease"
Takayasu's arteritis
Vasculitis that primarily affects asian females <40 years old
Takayasu's arteritis
Vasculitis w/ unilateral headache, jaw claudication & impaired vision
Temporal arteritis
Vasculitis a/w Hepatitis B
Polyarteritis nodosa
Vasculitis that affects renal & visceral veins w/ lesions of different ages
Polyarteritis nodosa
Triad of vasculitis, granulomas in lungs & airway, & glomerulonephritis
Wegener's granulomatosis
Vasculitis that is an acute, self-limiting disease of infants/kids
Kawasaki disease
Most common form of childhood systemic vasculitis
Henoch-Schonlein purpura
Skin rash, arthralgia, intestinal hemorrhage, abdominal pain & melena in kids
Henoch-Schonlein purpura
AV malformation in small vessels
Telangiectasia
ANA
Antinuclear antibody
a/w SLE
Anti-dsDNA
Anti double stranded DNA
a/w SLE(more specific than ANA)
Anti-Smith
a/w SLE (more specific than ANA)
Anti-histone
a/w Drug-induced lupus
Anti-IgG
aka Rheumatoid factor
a/w Rheumatoid arthritis
C-ANCA
Antineutrophil cytoplasmic Ab
a/w Vasculitis
P-ANCA
Antineutrophil cytoplasmic Ab
a/w Vasculitis
Anticentromere
a/w Scleroderma (CREST)
Anti-Scl-70
a/w Scleroderma (Diffuse)
Anti-epithelial cell
a/w Pemphigus vulgaris
Anti-Jo-1
a/w Polymyositis & dermatomyositis
HLA a/w:
Ankylosing spondylitis
HLA-B27
HLA a/w:
Reiter's Syndrome
HLA-B27
HLA a/w:
SLE
HLA-DR2
HLA a/w:
Rheumatoid Arthritis
HLA-DR4
What layer of skin does bullous pemphigoid affect?
Subepidermal blisters
What layer of skin does impetigo affect?
Subcorneal blisters
What layer of skin does pemphigus vulgaris affect?
Intraepidermal blisters
What layer of skin does eczema affect?
Intraepidermal blisters
What layer of skin does dermatitis herpetiformis affect?
Subepidermal blisters
Flat circumscribed lesion less than 5 mm in diameter
Macule
Flat circumscribed lesion more than 5 mm in diameter
Patch
Elevated lesion less than 5 mm in diameter
Papule
Elevated lesion with spherical contour greater than 5 mm in diameter
Nodule
Elevated flat-topped lesion, usually greater than 5 mm in diameter
Plaque
Fluid-filled raised lesion less than 5 mm in diameter
Vesicle
Fluid-filled raised lesion greater than 5 mm in diameter
Bulla
Common term used for vesicle or bulla
Blister
Discrete, pus-filled, raised lesion
Pustule
Itchy, transient, elevated lesion with variable blanching and erythema
Wheal
Dry, horny, platelike excrescence
Scale
Thickened and rough skin characterized by prominent skin markings
Lichenification
Dried exudates from vesicle, bulla, or pustule; over superficial shallow erosions
Crust
Traumatic lesion characterized by breakage of the epidermis, causing a raw linear area
Excoriation
Separation of nail plate from nail bed
Onycholysis
Thickening of the stratum corneum
Hyperkeratosis
A break in the skin, usually where it joins a mucous membrane, producing a crack-like sore or ulcer
Fissure
Modes of keratinization characterized by the retention of the nuclei in the stratum corneum
Parakeratosis
Hyperplasia of the stratum granulosum
Hypergranulosis
Diffuse epidermal hyperplasia
Acanthosis
Surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae
Papillomatosis
Abnormal keratinization occurring prematurely within individual cells or groups of cells below the stratum granulosum
Dyskeratosis
Loss of intercellular connections resulting in loss of cohesion between keratinocytes
Acantholysis
Intercellular edema of the epidermis
Spongiosis
Intracellular edema of keratinocytes
Hydropic swelling
Infiltration of the epidermis by inflammatory or circulating blood cells
Exocytosis
Discontinuity of the skin exhibiting incomplete loss of the epidermis
Erosion
Discontinuity of the skin exhibiting complete loss of the epidermis and often of portions of the dermis and even subcutaneous fat
Ulceration
Formation of vacuoles within or adjacent to cells
Vacuolization
Referring to a linear pattern of melanocyte proliferation within the epidermal basal cell layer
Lentiginous
What is normal transepidermal water loss?
150 mL/day
How does TEWL change after loss of the stratum corneum?
TEWL increases by a factor of 50
Genetics of Dysplastic nevi syndrome
Autosomal dominant
Involves genes on chrom 1, 9 or 12
Genetics of Basal cell nevus syndrome
Autosomal dominant
Mutated ptc gene on chrom 9q22
Epidermodysplasia veruciformis is a/w what?
HPV types 5 & 8
Flat, red warts all over the skin; genitals are usually spared
Epidermodysplasia veruciformis
Disorder characterized by blister formation in response to mechanical trauma
Epidermolysis bullosa
Nevi that are larger than normal and may occur as hundreds of lesions on the body
Dysplastic nevi syndrome
Skin cancer w/ windblown histologic appearance
Squamous cell carcinoma
Skin cancer w/ pink, amorphous areas because of keratin production
Squamous cell carcinoma
Bowen's syndrome
Squamous cell carcinoma in situ
Most common skin cancer
Basal cell carcinoma
Skin cancer w/ basophilic staining
Basal cell carcinoma
Skin cancer w/ Peripheral palisading
Basal cell carcinoma
Skin cancer w/ bcl-2, α-SMA & Stromolysin 3 mutations
Basal cell carcinoma
Least common skin cancer
Melanoma
Most common type of melanoma
Superficial spreading melanoma
Rarest type of melanoma
Nodular melanoma
Clark staging
based on level of invasion
levels 1-5
Breslow staging
based on thickness of lesion
<.75mm= good prognosis
Best prognostic indicator
Erythematous macule leading to multiple small pustules; rupture and ULCERATE with thick crust
Ecthyma
Usually a neglected impetigo that progresses
Erythematous macule leading to multiple small pustules; rupture and FORM EROSIONS covered in crust
Impetigo
Acute, deep-seated, red, hot, tender nodule or abscess
Furuncle
Deeper infection (than furncle) comprised of interconnecting abscesses usually arising in several contiguous hair follicles
Carbuncle
Crops of small pustules centered around hair shaft, erythema
Folliculitis
Cause of Erysipelas
group A β-hemolytic streptococci
Cause of Cellulitis
Staphylococcus aureus
Red, hot, edematous and shiny plaque that may contain vesicles, bullae, erosions or abscesses
Erysipelas (defined boders) & Cellulitis (ill-defined borders)
Cause of Erythrasma
Corynebacterium minutissimum
Sharply marginated macule; scaling, erosion, fissure can occur
Erythrasma
Shows a coral-red fluorescence w/ Wood's lamp
Erythrasma
Cause of Pitted Keratolysis
Micrococcus sedentarius
Pits in stratum corneum; Sometimes discrete, oftentimes large areas of eroded corneum form; white when hydrated
Pitted Keratolysis
Cause of Green Nail Syndrome
P.aeurginosa
usually acquired by prolonged exposure to water
Superficial papules and pustules with erythematous halo on parts of body that are covered by shorts
“Hot Tub” Folliculitis
Erythematous macule → infarction → bullae → ulcer;
a/w fever, chills, and tenderness in hospitalized/ immunocompromised patients
Ecthyma Gangrenosum
Painless ulcer/chancre @ site of inoculation; Hard, clean edge with a yellowish base
Primary Syphilis
Firm macules and papules that are pink, brownish-red; Scaly macules on palm; condyloma lata
Secondary Syphilis
Plaques and nodules with scars healed in center with/without scales and with/without ulceration
Tertiary Syphilis
Jarish-Herxheimer Syndrome
Flu-like symptoms within first 24 hours of treatment of syphillis; Normal process caused by lysing of spirochetes
Condyloma acuminatum
Verrucae (warts) in genital region
Flat to convex papules with rough, pebble-like surface
Verrucae (warts)
Cause of Molluscum Contagiosum
poxvirus
Firm, umbilicated (dent in the center), dome- shaped papules, shiny; Pruritic
Molluscum Contagiosum
How is latency formed w/ Herpes simplex virus
Virus ascends in peripheral sensory nerves and enters dorsal root ganglia where latency is established
Groups of small vesicles and shallow ulcers on erythematous base (pustules→erosions→crust)
Typical herpes lesions
Patches of erythema, small erosions, fissures, or subclinical lesions
Atypical herpes lesions
"Dewdrops on a rose petal"
Herpes Zoster
Erythematous/Edematous base with superimposed clear vesicles w/ unilateral dermatome distribution
Herpes Zoster
Most common dermatophyte infection
Trichophyton rubrum
MCC of Tinea Capitas
Trichophyton tonsurans
Athlete's foot
Tinea Pedis
Dermatophyte infection on scalp
Tinea Capitas
Dermatophyte infection on face
Tinea Facialis
Dermatophyte infection in inguinal region
Tinea Cruris
Dermatophyte infection on trunk/extremities
Tinea Corporis
Dermatophyte infection on hand
Tinea Manuum
Dermatophyte infection from pets
Microsporum canis
sharply demarcated, polycyclic, erythematous, eroded patches with small pustular lesions; base can be scraped away w/ gauze
Candidiasis
Cause of Pityriasis (tinea) versicolor
Malassezia furfur
Well-demarcated scaling patches with variable pigmentation; Macules that are sharply marginated, round/oval in shape, with varying size
Pityriasis (tinea) versicolor
"Spaghetti and meatballs" appearance on KOH stain
Pityriasis (tinea) versicolor
Cause of scabies
Sarcoptes scabiei mite
Gray/skin-colored ridges from 5mm to 10cm in length
Scabies
Cause of Pediculosis
The arthropod Phthirus
Hair lice
Pediculosis caused by Phthirus Humanus capitas
Genital crabs
Pediculosis caused by Phthirus pubis
Tx of Acne vulgarus
Tretinoin/Adapalene(retenoids) & Tetracyclines
Tx for Gadolinium induced systemic sclerosis
Phototherapy
Topical agent used to treat S. aureus and most Strep except group D
Mupirocin
Topical agent used to treat dermatophyte infections
Griseofulvin
Topical/oral agent used to treat dermatophyte infections
Terbinafine (an allylamine)
Topical agent that is very effective on yeasts
Nystatin
Tx of ectoparasites
Permethrin (preferred tx) & Lindane (not used as much due to neurotoxicity)
Tx of psoriasis
Methotrexate(antimetabolite) & Cyclosporin (Calcineurin inhibitor)
Topical Tx of actinic keratosis, Bowen’s disease and superficial basal cell carcinoma
5-fluorouracil
Tx of atopic dermatitis
Tacrolimus & Pimecrolimus(mild to moderate cases)
Both are calcineurin inhibitors
Patients on Calcineurin inhibitors must do what?
Wear sunscreen when outside due to cutaneous immunosuppresion that could lead to skin cancer
Biological agent that binds 2 molecules of TNF
Etanercept
Biological agent that binds to the TNF receptor
Infliximab
MCC of dwarfism
Achondroplasia
Cause of Achondroplasia
defect in a fibroblast growth factor receptor protein (FGFR3)
Found on chrom 4
MCC of osteomyelitis
S. aureus
MCC of osteomyelitis a/w GU infections
E. Coli, Pseudomonas, Klebsiella
MCC of osteomyelitis a/w drug abuse
E. Coli, Pseudomonas, Klebsiella
MCC of osteomyelitis in neonates
H. Influenzae and Group B Strep
MCC of osteomyelitis in pt's w/ sickle cell disease
Salmonella
Pott's disease
Tuberculosis osteomyelitis involving the spine
Muscle disease w/ LMN signs
Poliomyelitis
Muscle disease w/ both UMN & LMN signs
Amyotrophic lateral Sclerosis
Muscle disease seen in infants ("floppy baby")
Werdnig-Hoffmann disease
Symmetric ascending muscle weakness beginning in distal and lower extremities
Guillain-Barre Disease
Genetics of Duchenne Muscular Dystrophy
X-linked recessive
Complete absence of dystrophin gene
Genetics of Becker’s Muscular Dystrophy
X-linked recessive
Mutation causing production of truncated dystrophin
Defect in Oculopharyngeal dystrophy
PABPN1(Poly-A binding protein, nuclear 1) gene on chrom 14
GCG trinucleotide expansion
Defect in limb-girdle dystrophy
Mutation of laminin
Defect in Emery-dreifuss dystrophy
Mutation of emerin(X-linked)
Less commonly, mutation of laminin
Defect in myotonic dystrophy
DMPK (dystrophila myotonia-protein kinase) gene on chrom 19
CTG trinucleotide expansion
Defect in Nemaline myopathy
ACTA 1 gene on chrom 1; threadlike; dark inclusions of Z-band material in type I fibers
Defect in Central Core Disease
RYR 1 gene on chrom 19; codes for a calcium release channel; a/w malignant hyperthermia
Kearns-Sayre Syndrome
Ophthalmoplegia plus retinal pigmentary degeneration and complete heart block
Caused by large deletion of mitochondrial DNA
Dermatomyositis
Heliotrope rash with periorbital edema; Muscle weakness; myocarditis; interstitial lung dx, 40% have cancer too