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186 Cards in this Set
- Front
- Back
layers of epidermis from surface to base?
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Corneum
Lucidum Granulosum Spinosum Basalis |
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junctions involved in zona occludens?
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tight junctions; maintain cell polarity and prevent diffusion across paracellular space
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junctions involved in zona adherens?
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intermediate junction; cadherins attached to actin
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macula adherens?
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desmosomes creating small discrete sites of attachment (rivits); cadherins attached to intermediate filaments
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role of integrins in cell junctions?
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maintains ingetrity of basement membrane; binds to laminin in BM
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role of hemidesmosomes in cell junctions?
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connects cells to underlying extracellular matrix
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unhappy triad of knee injury?
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(due to lateral force)
MCL ACL Lateral meniscus |
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abnormal passive abduction of knee?
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indicates torn MCL
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positive anterior drawer sign?
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indicates tearing of ACL
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rotator cuff muscles?
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Supraspinatus
Infraspinatus teres minor Subscapularis |
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actions of supraspinatus?
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initial abduction of arm (before deltoid)
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most common rotator cuff injury?
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supraspinatus
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actions of infraspinatus?
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laterally rotates arm
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pitcher's rotator cuff injury?
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infraspinatus
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actions of teres minor?
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adducts and laterally rotates arm
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actions of subscapularis?
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medially rotates and adducts arm
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nerve compressed by incorrect use of a crutch?
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radial nerve
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nerve compressed by supracondylar fracture of humerus?
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median nerve at elbow
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nerve lesioned by fracture of medial epicondyle of humerus?
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ulnar nerve
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nerve compressed in carpal tunnel syndrome?
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median nerve
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nerve lesioned by fracture of hook of hamate?
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ulnar nerve
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lateral hand nerve lesioned by superficial laceration?
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recurrent branch of median nerve
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nerve affected by subluxation of radius?
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deep branch of radial nerve
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nerve lesioned by midshaft fracture of humerus?
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radial nerve
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nerve lesioned by fracture of surgical neck of humerus or dislocation of humerus?
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axillary nerve
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dermatome including thumb and lateral hand?
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C6
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dermatome including middle finger?
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C7
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dermatome including ring and pinkie fingers?
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C8
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dermatome including medial forearm?
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T1
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dermatome including lateral upper arm?
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C5
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dermatome including axilla?
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T2
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dermatome including pointer finger?
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C6
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dermatome including lateral forearm?
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C6
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dermatome including shoulder?
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C4
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sensory innervation of palm of lateral hand (thumb, pointer, second, half of third fingers)?
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median nerve
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sensory innervation of palm of medial hand (half of ring and pinkie fingers)?
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ulnar nerve
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sensory innervation of back of lateral hand (thumb and base of first two fingers)?
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radial nerve
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sensory innervation of back of first two fingers?
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median nerve
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sensory innervation of back of lateral hand and pinkie and half of ring fingers?
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ulnar nerve
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nerve roots that contribute to axillary nerve?
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C5, C6
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nerve roots that contribute to radial nerve?
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C5-C8
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nerve roots that contribute to median nerve?
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C6-C8, T1
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nerve roots that contribute to ulnar nerve?
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C8, T1
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nerve roots that contribute to musculo-cutaneous nerve?
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C5-C7
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motor deficit following injury to axillary nerve?
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deltoid (failure of arm abduction at shoulder)
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motor deficit following injury to radial nerve?
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wrist drop; innervates brachioradialis, extensors of wrist and fingers, supinators, triceps
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motor deficit following injury to proximal median nerve?
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"ape hand" (loss of opposability of thumb); innervates muscles for lateral finger flexion and wrist flexion
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motor deficit following injury to distal median nerve?
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loss of opposition of thumb
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motor deficit following injury to proximal ulnar nerve?
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medial finger flexion and wrist flexion
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motor deficit following injury to distal ulnar nerve?
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abduction and adduction of fingers, adduction of thumb, extension of 4th and 5th fingers
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motor deficit following injury to musculocutaneous nerve?
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flexion of arm at elbow; innervates biceps, brachialis, coracobrachialis
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ulnar deviation of wrist upon wrist flexion?
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distal median nerve lesions
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radial deviation of wrist upon wrist flexion?
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proximal ulnar nerve lesion
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hand of benediction?
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distal ulnar nerve lesion
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nerve lesion leading to wrist drop?
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radial nerve
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nerve lesion leading to winged scapula?
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long thoracic nerve
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nerve roots that contribute to long thoracic nerve?
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C5-C7
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actions of dorsal vs. palmar interosseous muscles?
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Dorsal: ABduct
Palmar: ADduct |
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nerve responsible for thigh adduction?
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Obturator (L2-L4)
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nerve responsible for thigh flexion?
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Femoral (L2-L4)
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nerve responsible for leg extension?
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Femoral (L2-L4)
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nerve responsible for foot eversion and dorsiflexion?
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common peroneal (L4-S2)
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nerve responsible for foot inversion and plantarflexion?
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Tibial (L4-S2)
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nerve responsible for thigh abduction?
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superior gluteal (L4-S1)
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nerve lesion leading to foot drop?
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common peroneal (L4-S2)
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nerve lesion leading to Trendelenburg sign?
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superior gluteal (L4-S1)
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nerve lesion leading to inability to jump, climb stairs, or rise from seated position?
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inferior gluteal (L5-S2)
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nerve roots that contribute to sciatic nerve?
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L4-S2
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nerve lesion caused by anterior hip dislocation?
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Obturator (L2-L4)
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nerve lesion caused by pelvic fracture?
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Femoral (L2-L4)
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nerve lesion caused by trauma to lateral aspect of leg?
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common peroneal (L4-S2)
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nerve lesion caused by knee trauma?
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Tibial (L4-S2)
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nerve lesion caused by posterior hip dislocation?
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superior gluteal (L4-S1) or inferior gluteal (L5-S2)
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nerve lesion caused by polio?
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superior gluteal (L4-S1)
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in muscle contraction, calcium released from sarcoplasmic reticulum binds to what protein?
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troponin C; causes conformational change that moves tropomyosin out of myosin binding groove on actin filaments
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in muscle contraction, what is responsible for exposing myosin-binding groove on actin filaments?
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calcium binding to troponin C causing conformation change
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during muscle contraction, what part of sarcomere does not change length?
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A band
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type 1 muscle fibers?
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slow twitch; red fibers (increased mitochondria); increased oxidative phosphorylation; good for sustained contraction
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type of muscle fibers with increased capacity for anaerobic glycolysis?
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type 2 fibers
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mechanism of flat bone growth?
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(membranous ossification)
woven bone formed directly without cartilage then remodeled to lamellar bone |
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where are stem cells for osteoblasts?
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mesenchymal stem cells in periosteum
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mechanism of long bone growth?
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(endochondral ossification)
cartilaginous model made by chondrocytes then replaced with woven bone and remodeled to lamellar bone by osteoclasts and osteoblasts |
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mutation in what molecule causes achondroplasia?
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FGFR3 (fibroblast growth factor receptor); constitutively active form leads to inhibition of chondrocyte proliferation and failure of longitudinal bone growth
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role of exogenous PTH in treating osteoporosis
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can give in pulsatile doses for severe cases
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cause of osteopetrosis?
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abnormal function of osteoclasts due to genetic deficiency of carbonic anhydrase II
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Erlenmeyer flask bones on x-ray
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osteopetrosis; associated with anemia, thrombocytopenia, infection
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osteoporosis vs. osteomalacia?
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osteomalacia due to increased PTH; osteoporosis associated with normal lab values
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long bone chalk-stick fractures?
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paget's disease (abnormal bone architecture caused by increase in osteoblastic AND osteoclastic activity)
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lab abnormality in paget's disease?
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increased alkaline phosphatase (unlike osteopetrosis)
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McCune-Albright syndrome?
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form of polyostotic fibrous dysplasia; multiple bone lesions with endocrine abnormalities and pigmented skin lesions
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café-au-lait spots and precocious puberty?
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McCune-Albright syndrome; associated with bone lesions (bone replaced by fibroblasts, collagen, and irregular trabeculae)
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new piece of bone growing on another bone, often in skull?
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Osteoma; associated with Gardener's syndrome (FAP condition)
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double bubble or soap bubble appearance on x-ray of knee?
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osteoclastoma (giant cell tumor)
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histology of osteoclastoma (giant cell tumor)
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(often seen in knee region)
spindle-shaped cells with ultinucleated giant cells |
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most common benign bone tumor?
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osteochondroma
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benign cartilaginous neoplasm found in intramedullary bone?
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enchondroma
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peak incidence of osteosarcoma?
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men 10-20 years old
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sunburst pattern on x-ray of knee?
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osteosarcoma
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Codman's triangle on x-ray of knee?
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osteosarcoma
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small blue cell malignant tumor of bones with early mets?
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ewing's sarcoma
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peak incidence of ewing's sarcoma?
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boys <15 yo
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onion-skin appearance in bone?
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ewing's sarcoma
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genetic mutation associated with ewing's sarcoma?
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t(11;22)
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t(11;22)
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ewing's sarcoma
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expansile glistening mass within medullary cavity?
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chondrosarcoma (malignant cartilaginous tumor)
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peak incidence of chondrosarcoma?
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men age 30-60
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Heberden's and Bouchard's nodes?
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osteoarthritis:
Heberden's on DIP Bouchard's on PIP |
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finger joints involved in RA?
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MCP and PIP
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type of hypersensitivity reaction involved with RA?
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type III (immune complex mediated)
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HLA association of RA?
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HLA-DR4
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rheumatoid factor
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anti-IgG antibody associated with RA
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dry eyes, dry mouth, arthritis?
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Sjogren's
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risk of what liquid tumor is increased in sjogren's
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B cell lymphoma
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antibodies in sjogren's?
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SS-A (Ro) and SS-B (La)
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Sicca syndrome?
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dry symptoms of sjogren's but no arthritis
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congenital condition associated with gout?
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Lesch-Nyhan
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gout crystals?
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needle-shaped, negatively birefringent (yellow under parallel light)
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pseudogout crystals?
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(calcium pyrophosphate)
rhomboid, weakly positive birefringent (yellow under perpendicular light, blue under parallel light) |
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meds for chronic gout?
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allopurinol, probenecid
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causes of chronic infectious arthritis?
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TB, Lyme disease
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rheumatologic-y arthritis conditions that are RF negative?
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Psoriatic arthritis
Ankylosing spondylitis Inflammtory bowel disease Reactive arthritis |
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HLA association of seronegative spondylo-arthropathies?
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HLA-B27
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symptoms associated with ankylosing spondylitis?
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stiff spine, uveitis, aortic regurgitation
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reactive arthritis?
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(Reiter's syndrome)
"can't see, can't pee, can't climb a tree" post-GI or chlamydia infections |
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kidney findings in SLE?
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wire-loop lesions on histology with immune complex deposition
usually causes nephritic syndrome |
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cardiac findings in SLE?
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nonbacterial verrocous endocarditis (Libman-Sacks)
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cause for false positive syphilis tests in SLE?
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antiphospholipid antibodies
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serum finding in drug-induced lupus?
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antihistone antibodies
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immune-mediated, widespread noncaseating granulomas?
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sarcoidosis
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Bell's palsy, hypercalcemia, epithelial granulomas?
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sarcoidosis
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serum levels of what enzyme are increased in sarcoidosis?
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ACE
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treatment for sarcoidosis?
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steroids
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pain and stiffness in shoulders and hips, fever, weight loss; no muscular weakness
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polymyalgia rheumatica
has elevated ESR |
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treatment for polymyalgia rheumatica?
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prednisone
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heliotrope rash?
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dermatomyositis
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shawl rash?
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dermatomyositis
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progressive symmetric proximal muscle weakness with biopsy showing perifascicular inflammation?
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polymyositis
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mechanism of muscle weakness in polymyositis?
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CD8+ T-cell mediated injury to myofibers
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antibodies in polymyositis/dermatomyositis?
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ANA, anti-Jo1
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neoplasm associated with myasthenia gravis?
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thymoma
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muscle weakness that improves with muscle use?
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Lambert-Eaton (autoantibodies to presynaptic calcium channel); associated with small cell lung cancer
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antibody in diffuse scleroderma?
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anti-Scl-70
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CREST syndrome?
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Calcinosis
Raynaud's Esophageal dysmotility Sclerodactyly Telangiectasia (limited skin involvement) |
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antibody in CREST syndrome?
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anti-Centromere
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acantholysis?
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separation of epidermal cells seen in pemphigus vulgaris
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increased thickness of stratum corneum?
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hyperkeratosis; seen in psoriasis
|
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acanthosis?
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epidermal hyperplasia (increase in stratum spinosusm)
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infectious agent associated with keloid formation?
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T. pertenue
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verrucae
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warts
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ephelis
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freckle
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type of hypersensitivity reaction involved with allergic contact dermatitis?
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type IV
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plaques with silvery scaling?
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psoriasis
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acanthosis with parakeratotic scaling?
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psoriasis
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auspitz sign?
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sign of psoriasis (bleeding spots when scales are stripped off skin)
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seborrheic keratosis
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keratin-filled cysts "pasted on" skin; common benign lesions of elderly
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hyperpigmentation associated with pregnancy/OCP use?
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melasma or chloasma
|
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mechanism of albinism vs. vitiligo?
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albinism: normal melanocyte number, decreased production
vitiligo: decrease in number of melanocytes |
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developmental cause of albinism?
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failure of neural crest cell migration
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honey-colored crusting?
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impetigo; commonly caused by S. aureu or S. pyogenes
|
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common causes of cellulitis?
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S. pyogenes or S. aureus
|
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common causes of necrotizing fasciitis?
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S. pyogenes or anaerobic bacteria
|
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layer of epithelium targetted in staphylococcal scalded skin syndrome?
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stratum granulosum (keratinocyte attachments)
|
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white painless plaques on tongue that cannot be scraped off in HIV patients?
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hairy leukoplakia; EBV mediated
|
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more severe blistering disorder?
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pemphigus vulgaris
|
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antibody involved in pemphigus vulgaris?
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IgG antibody against desmosomes
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nikolsky's sign?
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separation of epidermis upon manual stroking of skin; positive in pemphigus vulgaris
|
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antibody involved in bullous pemphigoid?
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IgG antibody against hemidesmosomes
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immuno-fluoresecence in bullous pemphigoid?
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linear (basement membrane)
|
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pruritis, purple polygonal papules?
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lichen planus; associated with hep C
|
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layer of epithelium involved in acanthosis nigricans?
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stratum spinosum
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herald patch followed by christmas tree distribution?
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ptiyriasis rosea
|
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leukotriene that functions as agent for neutrophil chemotaxis?
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LTB4
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leukotrienes that function in bronchoconstriction?
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LTC4, LTD4, LTE4
|
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arachidonic acid derivative that inhbits platelet aggregation and promotes vasodilation?
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prostacyclin PGI2 (also decreases uterine tone)
|
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end products of COX1 and COX2 enzymes?
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prostacyclins, prostaglandins, thromboxanes
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actions of thromboxane TXA2?
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increases platelet aggregation and vasoconstriction
|
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selective COX-2 inhibitors increase risk of what?
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thrombosis
|
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mechanism of acetaminophen-related hepatic necrosis?
|
metabolite depletes glutathione and forms toxic tissue adducts in liver
(N-acetylcysteine regerates glutathione) |
|
mechanism of bisphonphonates?
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(etidronate, alendronate)
inhibits osteoclastic activity |
|
mechanism of colchicine?
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stabilizes tubulin, impairing leukocyte chemotaxis and degranulation
|
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mechanism of probenecid?
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inhibits reabsorption of uric acid in proximal collecting tubule (used in chronic gout)
|
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mechanism of allopurinol?
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inhibits xanthine oxidase, used in chronic gout
|
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interaction of salicylates on uric acid metabolism?
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all but highest doses cause impaired tubular secretion, worsen gout
|
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gout has to do with what metabolite pathway?
|
purine metabolism (generates hypoxanthine, xanthine, uric acid)
|
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recombinant form of TNF receptor that binds TNF?
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etanercept
|
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anti-TNF antibodies?
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infliximab, adalimumab
|