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