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67 Cards in this Set

  • Front
  • Back
tight junction
zona occludens
intermediate junction
zona adherens
actin and e-cadherens
macula adherens
keratin and desmoplakin
phospholambin does what?
inhibits the ATPase when the skeletal mm contraction is done
smooth muscle contraction- after calsium is released what happens?
Ca binds to calmodulin and activates myosin light chain kinase and this causes myosin and actin to go from contraction to myosin-P and actin (cross bridge formation)
how do you get the P off myosin during SM contraction?
myosin light chain phosphatase
Achondroplasia- what is effected membranous ossification or cartilage maturation?
cartilage maturation effected due to mutation due to FGF-R3 in growth plate
where does membranous ossification take place?
skull, facial boneas and axial skeleton
wear and tear of joints
destruction of articular cartilage
subchondral cysts, sclerosis, osteophytes, eburnation

Heberden's nodes (DIP)
Bouchard's nodes (PIP)
what will you see in the joint with oseoarthritis?
thickened capsule
synovial hypertrophy
Rheumatoid arthritis
anti-IgG antibody with morning stiffness improving with use
synovial joints with pannus formation in MCP and PIP, subcutaneous nodules, subluxation and ulnar devation
what are the systemic signs of RA?
fever fatigue pleuritis and pericarditis
osteoporsis- reduced ___ in spite of _______
bone mass: mineralization

sparse trabeculae

whites> blacks > asians
Type I and II osteoporosis and the fractures associated with each?
type I- postmenopausal bone resorption due to decreased estrogen

type II- senile osteoporosis; men and women >70yrs

type I- vertebral crush fractures- kyphosis (& loss of height)
Type II-distal radius Colle's fracture, vertebral wedge fractures
what is the TX for RA?
bisphosphonates or pulsatile PTH for severe cases
(marble bone disease)
failure of normal bone resorption- thick dense bone
-due to osteoclast malfxn
-decreased marrow space can lead to anemia, thrombocytopenia and infection
-normal Ca P and alkphos
osteomalacia (Rickets)
defective mineralization of osteoid- soft bones
-vit D defic causes dec Ca adn increased PTH and thus dec serum phos
-reversed with vit D administration
osteitis fibrosa cystica
caused by hyperPTHism
-"brown tumors" cystic spaces lined by clasts and fibrous stroma and (blood)
-high ca, low phos and high alk phos
Boutonniere deformity and swan-neck deformity and Z thumb deformity
-assoc with RA
PIP, DIP and thumb joint
-assoc with RA
Pagets disease
abnormal bone architec caused by increased in clasts and then blasts
-only alk phos is elevated
-chalkstick fractures
- fibroblasts endothel cells and vascularity are increased
-high output cardiac failure
Polyostotic fibrous dysplasia
bone replaced by fibroblasts, collagen and irrerg trabecula
-Albrights syndrome- mult unilat bone lesions assoc with endo abnormalities (precoc puberty) and unilat skin pigmentation
Polymyalgia rheumatica
pain in shoulders and hips
- not assoc with mm weakness
- temp arteritis assoc
-tx: prednisone
polymyositis/ dermatomyositis
POLYMYOSITIS-progressive symmetric prox mm weakness
-CD8 T cell induced injury to myofibrils

DERMATOMYOSITIS: similar to poly but has shawl and face skin rash and increased risk for malig

labs: inc CK aldolase and ANA and anti-jo1
Reynauds phenomenon, arthralgia, myalgia and esoph hypomotility

-U1RNP Ig's and responds to steroids
Sjogrens syndrome
xerothalmia xerostomia (dry mouth, dysphagia) arthritis
-parotid enlargement and incr risk of B cell lymphoma
-dental caries
-anti SS-A (ro) SS-B (la)
-female 40-60yrs
sjogrens is assoc with ____ and ___ syndrome
- SICCA SYNDROME: dry eyes and dry mouth, nasal and vag dryness and chronic bronchitis and reflux esophagitis
non caseating granulomas and inc ACE
-black females
-restric lung disease, bilateral hilar lymphadeno, erythema nodosum, bells palsy
-epith granulomas containing Schaumann and asteroid bodies
-uveoparotitis and hypercalcemia
-BC VIT D is conv to its active form
erythema nodosum
-assoc with sarcoidosis
-inflamm of fat cells under the skin on both shins due to exudation of blood and serum
calcium pyrophos crystals that are weakly pos bifringent
-in lg joints (knee)
->50 yrs old and men = women
monosodium urate crystals
-lesh-nyhan ,PRPP excess, G6PD defic
-assoc with thiazides that competit inhibit secretion of uric acid
-assym joint distib
-podagra in big toe
-tophus formation on ear or achilles tendon
-neg bifring crystals
-black females
-non bacterial verrucous endocarditis
-wire loop lesions in kidney
-death from renal failure and infx
-false pos on syphillis test (anti phoslipid Ig)
-sensit but not spec for SLE ana
-anti-dsDNA, spec, poor prog
-anti-sm Ig, spec but not prognostic
-anti-histone Ig- drug induced lupus
(photosensit and discoid rash)
ankylosing spondylitis
-sacroileac joints and spine, uveitis and aortic regurg
-arthritis, conjunc, and urethritis
-post GI or chlamydial infxn
-progressive systemic sclerosis-PSS
excessive fibrosis and collagen throughout body- 75% female
-commonly skin but also GI kidney and cardiovascular
what are the 2 types of scleroderma?
diffuse- widespread skin involvement, rapidly progressing with early visceral involvement.
-anti -Scl-70 Ig

CREST syndrome- Calcinosis, Raynauds phenom, Esoph dysmotility, Sclerodactyly and Telangiectasia
-limited skin involvement (fingers and face) more benign course
-anti-centromere Ig
honey crusting lesions highly contagious
inflamm pruritic skin disorders (chemical injury of infxn)
HypSen rxns usually type IV
Atopic dermatitis
pruritic eruption usu on flexor surface
often assoc with other atopic diseases (asthma, allergic rhinitis)
allergic contact dermatitis
Type IV hypsen rxn that follows exposure to allergen (poison ivy)
epidermal hyperplasia (acanthosis) with parakeratotic scaling (nucleii still in strat corneum)
-esp on knees and elbows
-increased stratum spinosum and decreased granulosum
-Auspitz sign
Dermatitis herpetiformis
assoc with celiac disease
-IgA at the tips of dermal papillae
Lichen planus
pruritic purple polygonal papules with lymphocytes at the dermalepidermal junction (localized baldness)
erythema multiforme
assoc with infections drugs cancer and autoimmune dis.
- multiple types of lesion and "target lesions"
Stevens-johnson syndrome
sulfa and anticonvulsant drugs (major form of erythema multiforme
high fever bullae formation and ulceration of the skin and high mortality rate
-multiple mucous membrane involvement
Seborrheic keratosis
flat pgmented sq epith proliferation with keratin filled cysts (horn cysts)
Actinic Keratosis
caused by sun exposure
-small rough erythematous brown papules
-PREMALIGNANT risk of carcinoma is proportional to epith dysplasia
african americans with a tumor of connective tissue elements that causes raised thickened scars
Bullous pemphigoid
autoimmune IgG against epidermal BM hemidesmosomes (linear immuno flourescence)
-similar to but less severe than pemphis vulgaris
-not in the mouth!
Pemphigus vulgaris
-potentially fatal autoimmune disorder
-intraepidermal bullae involving ORAL mucosa and skin
-acantholysis- breaking epith cell to cell jxn
-IgG against epidermal cell surface desmosomes
-immunoflour throughout epidermis

(MD- Macula adherens Desmosome (keratin and desmoplakin)
soft tan colored cauliflower lesions
epidermal hyperplasia, hyperkeratosis, koilocytosis
- HPV infects stratum basale
squamous cell carcinoma
very common!-excess sunlight, arsenic exposure
-hands and face and locally invasive
-rarely mets
-keratin pearls
-actinic keratosis precursor
basal cell carcinoma
most common in sun exposed areas
locally invasive- usu never mets
pearly papules on gross path
common tumor with risk of mets
sunlight exposure- depth correl with risk of mets
-DYSPLASTIC NEVUS is a precursor
giant cell tumor
epiphyseal end of long bones
double bubble and MNC giant cells
-men 20-40 yrs
MC benign bone tumor
bone with cartilage cap found at long metaphysis <25yrs male
-transformation to chondrosarcoma is rare
cartilage neoplasm of intramedullary bone usually distal extremities (unlike chondrosarcoma)
MC malig tumor of bone
10-20 male
-at metaphysis of long bone
-RF: pagets disease, bone infarcts, radiation, familial retinoblastoma and Codman's triangle (elevation of periosteum on Xray)
Ewings sarcoma
(11:22) <15yrs boys
aggressive with early mets responsive to chemo
- onion skinning
-diaphysis of long bones, pelvis, scapula and ribs
men 30-60yrs
-pelvis spine humerus scapula tibia femur
-can be 1ary or from osteochondroma
-expansile glistening mass in medullary cavity
Takayasu's arteritis
elevated ESR like temporal arter.
-Fever arthritis night sweats myaligia skin nodules ocular disturbances weak pulse in upper extrem
temporal arteritis
responds to steroids
half of patients have polymyalgia rheumatica (proximal mm pain and periarticular pain)
polyarteritis nodosa
necrotizing immune complex inflamm in muscular and renal and visceral aa
- neurological dysfunction and cutaneous eruptions
-Hep B seroposit in 30% pts
- multiple anyeurysms and constricts on angiogram (lesions of diff ages)
-TX corticosteroids and cyclophosphamide
C-ANCA hematuria and red cells casts
TX cyclophos. and corticosteroids
microscopic polyangiitis
like wegners but P-ANCA
Churg- Strauss
granulomatous vasculitis with eosinophilia. heart lung skin kidneys and nerves. seen in atopic pts
Kawasaki disease
self limiting disease of kids
-fever, congested conjunctiva, changes in LIPS and ORAL mucosa and lyphadenitis
-may devp coronary anyeurysms
-transmural inflamm
Heoch-Schonlein purpura
most common childhood systemic vasculitis
-palpable purpura, arthralgia, intestinal hemorr, abdominal pain and melena
-multiple lesions of the same age
AV malformation in small vessells
-looks like dilated capilary
-heridatary hemorragic telan. AD and presents with nose bleeds and skin discolorations