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186 Cards in this Set

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