Musculoskeletal/connective Tissue

Front 1

what type of ossification is not affected in achondroplasia?

Back 1

membranous - skull, facial bones, and axial skeleton are normal

Front 2

Heberden's nodes (DIP) and Bouchard's nodes (PIP)

Back 2

osteoarthritis

Front 3

pain in weight-bearing joints after use that improves with rest

Back 3

osteoarthritis

Front 4

destruction of articular cartilage, subchondral bone formation, sclerosis, osteophytes, and eburnation are associated with what?

Back 4

osteoarthritis

Front 5

what are joint mice? what are they associated with?

Back 5

osteophytes that fracture and float into synovial fluid along with fragments of separated cartilage - seen in osteoarthritis

Front 6

pannus formation in joints, especially MCP, PIP

Back 6

rheumatoid arthritis

Front 7

morning stiffness improving with use; symmetric joint involvement, and systemic symptoms (fever, fatigue, pleuritis, pericarditis)

Back 7

rheumatoid arthritis

Front 8

Rx for severe cases of osteoporosis?

Back 8

bisphosphonates or pulsatile PTH

Front 9

type I osteoporosis?

Back 9

postmenopausal - increased bone resorption due to decreased estrogen levels

Front 10

type II osteoporosis?

Back 10

senile osteoporosis - affects men and women over 70

Front 11

what types of fractures are associated with type I osteoporosis?

Back 11

vertebral crush fractures - acute back pain, loss of height, kyphosis

Front 12

what type of fractures are associated with type II osteoporosis?

Back 12

distal radius (Colles') fractures, vertebral wedge fractures

Front 13

in this disease there is a failure of normal bone resorption that leads to thickened, dense bones

Back 13

osteopetrosis (marble bone disease)

Front 14

in this disease osteoclasts function abnormally

Back 14

osteopetrosis

Front 15

what level of alk phos is osteopetrosis associated with?

Back 15

normal

Front 16

what causes osteitis fibrosa cystica?

Back 16

hyperparathyroidism

Front 17

this disease is characterized by 'brown tumors', high serum calcium, low serum phosphorus, and high alk phos

Back 17

osteitis fibrosa cystica

Front 18

these are cystic spaces lined by osteoclasts, filled with fibrous stroma and sometimes blood

Back 18

brown tumors (seen in osteitis fibrosa cystica)

Front 19

in this disease there is abnormal bone architecture caused by an increase in both osteoblastic and osteoclastic activity

Back 19

Paget's disease (osteitis deformans)

Front 20

what level of alk phos is Paget's disease associated with?

Back 20

increased (normal serum calcium, phosphorus, adn PTH)

Front 21

in this disease, bone is replaced by fibroblasts, collagen, and irregular bony trabeculae

Back 21

polyostotic fibrous dysplasia

Front 22

Albright's syndrome is a form of what?

Back 22

polyostotic fibrous dysplasia

Front 23

multiple unilateral bone lesions, unilateral ppigmented skin lesions, precocious puberty

Back 23

Albright's syndrome

Front 24

pain and stiffness in shoulders and hips, often with fever, malaise and weight loss; doesn't cause muscular weakness

Back 24

polymyalgia rheumatica

Front 25

what is polymyalgia rheumatica associated with?

Back 25

temporal (giant cell) arteritis; occurs in patients over 50

Front 26

is ESR increased or decreased in polymyalgia rheumatica?

Back 26

increased

Front 27

progressive proximal muscle weakness caused by CD8+ T cell-induced injury to myofibers

Back 27

polymyositis

Front 28

muscle biopsy with evidence of inflammation is diagnostic for what?

Back 28

polymyositis

Front 29

increased CK, increased aldolase, and positive ANA, anti-Jo-1

Back 29

polymyositis/dermatomyositis

Front 30

Raynaud's, arthralgias, myalgias, fatigue, esophageal hypomotility

Back 30

mixed CT disease

Front 31

antibodies to U1RNP?

Back 31

mixed connective tissue disease

Front 32

what is the classic triad of Sjogren's syndrome?

Back 32

xerophthalmia, xerostomia, arthritis

Front 33

patients with Sjogren's syndrome are at increased risk for what?

Back 33

B cell lymphoma

Front 34

what is enlarged in Sjogren's syndrome?

Back 34

parotids

Front 35

what patients does Sjogren's primarily affect?

Back 35

females between 40-60

Front 36

autoantibodies to ribonucleoprotein antigens, SS-A (Ro), SS-B (La)

Back 36

Sjogren's

Front 37

fever, fatigue, weight loss, nonbacterial verrucous endocarditis, hilar adenopathy, and Raynaud's

Back 37

SLE

Front 38

what are the kidney findings in SLE?

Back 38

wire loop lesions in kidney with immune complex deposition (with nephrotic syndrome)

Front 39

what part of the SI does celiac sprue tend to affect?

Back 39

jejunem

Front 40

what skin finding is celiac sprue associated with?

Back 40

dermatitis herpetiformis

Front 41

what malignancy is celiac sprue most strongly affiliated with?

Back 41

T cell lymphoma

Front 42

blunting of villi and lymphocytes in the lamina propria are suggestive of what?

Back 42

celiac sprue

Front 43

what type of crystals precipitate in gout?

Back 43

monosodium urate

Front 44

what type of diuretics is gout associated with?

Back 44

thiazide

Front 45

needle shaped negatively birefringent

Back 45

gout

Front 46

with what type of crystals is pseudogout associated?

Back 46

calcium pyrophosphate

Front 47

rhomboid crystals that are weakly positively birefringent

Back 47

pseudogout

Front 48

what type of joints does pseudogout usually affect?

Back 48

large joints, especially the knee

Front 49

what is the treatment for pseudogout?

Back 49

none

Front 50

pulmonary hemorrhages leading to hemoptysis, renal lesions leading to hematuria, anemia, crescentic glomerulonephritis

Back 50

Goodpasture's syndrome

Front 51

what type of hypersensitivity reaction does Goodpasture's represent?

Back 51

type II

Front 52

anti-glomerular basement membranes produce what type of staining on immunofluorescence?

Back 52

linear

Front 53

what population does Goodpasture's usually affect?

Back 53

men 20-40

Front 54

what level is elevated in sarcoidosis?

Back 54

ACE

Front 55

immune-mediated, widespread noncaseating granulomas common in black females

Back 55

sarcoidosis

Front 56

what do the epithelial granulomas contain in sarcoidosis?

Back 56

microscopic Schaumann and asteriod bodies

Front 57

why is hypercalcemia associated with sarcoidosis?

Back 57

elevated conversion of vitamin D to its active form in epitheliod macrophages

Front 58

restrictive lung disease, bilateral hilar lymphadenopathy, erythema nodosum, Bell's palsy are associated with what?

Back 58

sarcoidosis

Front 59

patients with what disorder have decreased sensitivity and often anergy to skin test antigens?

Back 59

sarcoidosis

Front 60

chronic inflammatory disease of spine and SI joints -> ankylosis, uveitis, and aortic regurgitation

Back 60

ankylosing spondylitis

Front 61

this disorder is characterized by excessive fibrosis and collagen deposition throughout the body

Back 61

scleroderma (progressive systemic sclerosis)

Front 62

widespread skin involvement, rapid progression, early visceral involvement

Back 62

diffuse scleroderma

Front 63

CREST syndrome

Back 63

calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia

Front 64

idiopathic, segmental, thrombosing vasculitis of intermediate and small peripheral arteries and veins; seen in heavy smokers

Back 64

Buerger's disease

Front 65

intermittent claudication, superficial nodular phlebitis, and cold sensitivity, severe pain in affected part (may lead to gangrene) are characteristic of what?

Back 65

Buerger's disease

Front 66

what is the treatment for Buerger's disease?

Back 66

quit smoking

Front 67

what type of arteries does Takayasu's arteritis affect?

Back 67

medium and large arteries

Front 68

granulomatous thickening of aortic arch and/or proximal great vessels; elevated ESR

Back 68

Takayasu's arteritis ("pulseless disease")

Front 69

who does Takayasu's arteritis primarily affect?

Back 69

Asian females under 40

Front 70

what are the symptoms of Takayasu's arteritis?

Back 70

fever, arthritis, night sweats, myalgia, skin nodules, ocular disturbances, weak pulses in upper extremities:
FAN MY SKIN On Wednesday

Front 71

this is the most common vasculitis that affects medium and small arteries, usually branches of the carotid

Back 71

temporal/giant cell arteritis

Front 72

unilateral headache, jaw claudication, impaired vision (occlusion of ophthalmic artery, which can lead to blindness)

Back 72

temporal/giant cell arteritis

Front 73

half of patients with temporal arteritis have what?

Back 73

systemic involvement and polymyalgia rheumatica (proximal muscle pain, periarticular pain)

Front 74

what is elevated in temporal arteritis? what is the treatment?

Back 74

elevated ESR; steroids are Rx

Front 75

necrotizing immune complex inflammation of medium-sized muscular arteries, typically involving renal and visceral vessels

Back 75

polyarteritis nodosa

Front 76

approximately 30% of patients with polyarteritis nodosa are seropositive for what?

Back 76

Hep B

Front 77

multiple aneurysms and constrictions are seen on angiogram in what disease?

Back 77

polyarteritis nodosa

Front 78

what is the treatment for polyarteritis nodosa?

Back 78

corticosteroids, cylophosphamide

Front 79

what is the triad associated with Wegener's granulomatosis?

Back 79

necrotizing vasculitis, necrotizing granulomas in the lung and upper airway, and necrotizing glomerulonephritis

Front 80

perforation of nasal septum, chronic sinusitis, otitis media, mastoiditis, cough, dyspnea, hemoptysis, and hematuria are associated with what disease?

Back 80

Wegener's granulomatosis

Front 81

what is a strong marker of Wegener's granulomatosis?

Back 81

C-ANCA

Front 82

what might be seen on chest x ray in Wegener's?

Back 82

large nodular densities

Front 83

what is the treatment for Wegener's?

Back 83

cyclophosphamide and corticosteroids

Front 84

this vasculitide is like Wegener's but lacks granulomas and is associated with P- or C-ANCA

Back 84

microscopic polyangitis

Front 85

this is a vasculitis limited to the kidney

Back 85

primary pauci-immune crescentic glomerulonephritis

Front 86

granulomatous vasculitis with eosinophilia that involves lungs, heart, skin, kidneys, nervous system; often seen in atopic patients

Back 86

Churg-Strauss syndrome

Front 87

this is an acute, self-limiting disease of infants/kids; acute necrotizing vasculitis of small/medium sized vessels; fever, congested conjunctiva, changes in lips/oral mucosa, lymphadenitis

Back 87

Kawasaki disease/ mucocutaneous lymph node syndrome

Front 88

what potentially serious outcome can result from Kawakaki disease?

Back 88

coronary aneurysms

Front 89

what is the most common form of childhood systemic vasculitis?

Back 89

Henoch-Schonlein purpura

Front 90

skin rash, arthralgia, intestinal hemorrhage, abdominal pain, and melena in kid?

Back 90

Henoch-Schonlein purpura

Front 91

where do giant cell bone tumors most commonly occur? in what age group?

Back 91

epiphyseal end of long bones - 20-40 years old

Front 92

this is a locally aggressive benign tumor often around the distal femur, proximal tibial region

Back 92

giant cell tumor

Front 93

what type of bone tumor has a 'soap bubble' or 'double bubble' appearance on x-ray?

Back 93

giant cell tumor

Front 94

spindle-shaped cells with multinucleated giant cells found in what type of benign bone tumor?

Back 94

giant cell tumor

Front 95

what is the most common benign bone tumor?

Back 95

osteochondroma (exostosis)

Front 96

this type of bone tumor is usually found in men <25 and commonly originates from long metaphysis

Back 96

osteochondroma

Front 97

this is a benign cartilaginous neoplasm found in intramedullary bone, usually in the distal extremities

Back 97

endochondroma

Front 98

what is the most common malignant tumor of bone?

Back 98

osteosarcoma

Front 99

this malignant bone tumor's peak incidence is in men 10-20 years old and is commonly found in the metaphysis of long bones

Back 99

osteosarcoma

Front 100

name some predisposing factors for osteosarcoma

Back 100

Paget's disease of bone, bone infarcts, radiation, and familial retinoblastoma

Front 101

Codman's traingle or sunburst pattern on x-ray

Back 101

osteosarcoma

Front 102

this is an anaplastic small blue cell tumor of bone most common in boys <15

Back 102

Ewing's sarcoma

Front 103

what is the characteristic appearance of Ewing's sarcoma?

Back 103

onion skin

Front 104

this malignant bone tumor is aggressive with early mets but is responsive to chemo; commonly appears in diaphysis of long bones, pelvis, scapula, and ribs

Back 104

Ewing's sarcoma

Front 105

what is the chromosomal translocation associated with Ewing's sarcoma?

Back 105

11; 22

Front 106

this is a malignant cartilaginous tumor most common in men 30-60

Back 106

chondrosarcoma

Front 107

where are chondrosarcomas usually located? what can they originate from?

Back 107

pelvis, spine, scapula, humerus, tibia, or femur; may be primary or from osteochondroma (rare)