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63 Cards in this Set
- Front
- Back
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Unhappy triad
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MCL tear
ACL tear Lateral meniscus |
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Abnormal passive abduction indicates what?
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torn MCL
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Postive anterior drawer sign indicates what?
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torn ACL
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What is the source of osteoblasts?
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mesenchymal stem cells in the periosteum.
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What type of bone is decreased in osteoporosis?
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Trabecular (spongy) bone
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Osteopetrosis
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Failure of osteoclasts and bone resporption. See thickened, dense bones that are prone to fracture.
Serum Ca, phosphate, and ALP are NORMAL. Decreased marrow space leads to anemia, thrombocytopenia, and infection. Genetic deficiency of CARBONIC ANHYDRASE II in OCLs! X-rays show erlenmeyer flask bones that flare out. Can result in cranial nerve impingement and palsies due to narrowed foramina. |
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Osteomalacia/rickets
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Defective mineralization/calcification of osteoid leading to soft bones.
Vit D def in adults --> dec Ca levels --> inc PTH --> dec serum phosphate. maybe Low Ca Low Phosphate normal ALP |
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What is the histo of rheumatoid nodules?
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fibrinoid necrosis surrounded by palisading histiocytes.
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RA: what type of hypersensitivity?
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Type III (immune complex mediated)
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Gout vs. pseudogout: joints
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Gout: Asymmetric, swollen, red, painful. Classic is painful MTP joint of the big toe (podagra).
Pseudogout: large joints (classically the knee) |
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Gout vs. pseudogout: crystals
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Gout: monosodium urate crystals. Needle shaped and negatively birefringent.
See yellow crystals under parallel light and blue when perpendicular Pseudogout: calcium pyrophosphate. Basophilic, rhomboid crystals that are weakly positively birefringent. Crystals are yellow when perpendicular and blue when parallel |
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Gout vs. pseudogout: demographics
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Gout: more common in men
Pseudogout: equal in both sexes. |
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Infectious arthritis: joints
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monoarticular, migratory arthritis with an asymmetrical pattern.
Think STD: Synovitis (knee), Tendonitis (hand), Dermatitis (pustules) Although, Neisseria gonorrhea can cause a RECURRENT infection because of its phase variation. |
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What drug can cause decreased excretion of uric acid?
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Thiazide diuretics.
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Pts with lupus give false positives for what antibody tests?
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RPR/VRDL tests b/c of antiphospholipid antibodies which cross react with the cardiolipin used in these tests.
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SLE: characteristics of antinuclear antibodies
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sensitive but not specific for SLE
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SLE: characteristics of anti-dsDNA
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Very specific, poor prognosis
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SLE: Anti-Smith antibodies (anti-Sm)
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Very specific, but not prognostic
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SLE: Antihistone antibodies
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Indicate drug induced lupus
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Pseudogout: assoc w what diseases?
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Wilson's disease, hemochromatosis, hyperparathyroidism
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Sarcoidosis: see inc levels of what 2 things?
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ACE
Calcium (due to elecated conversion of vit D to its active form in epithelioid macrophages) GRAIN Gammaglobulinemia Rheumatoid arthritis ACE increase Interstitial fibrosis Noncaseating granulomas |
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Myasthenia gravis: assoc w what malignancy?
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Thymoma
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What NMJ disorder can be caused by a paraneoplasm?
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Eaton-Lambert syndrome (antibodies to the presynaptic Ca2+ channels)
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Antibodies to U1RNP
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Mixed connective tissue disorder
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Diffuse scleroderma: antibodies?
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assoc w anti-Scl-70 (ant-DNA topoisomerase I antibody)
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CREST: what does it stand for? associated antibodies?
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Calcinosis
Raynaud's syndrome Esophageal dysmotility Sclerodactyly Telangiectasia More benign clinical course, assoc w anti-Centromere abs |
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Rhabdomyoma of the heart: think what?
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tuberous sclerosis
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Acantholysis: what does it mean and what disease do you see it in?
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separation of the epidermal cells
Seen in pemphigus vulgaris |
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Acanthosis: what does it mean?
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Epidermal hyperplasia
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Allergic contact dermatitis: what type of HSR?
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HSR type IV that follows an exposure to allergen.
From Th1 lymphocytes sec IFN- |
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Atopic dermatitis: what type of HSR?
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Type I HSR. Immediate reaction.
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SSSS: destroys attachments of what type and in what cell layer?
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Destroys keratinocyte attachments in the granulosum layer only!
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Pemphigus vulgaris: what type of immunoglobulin against what?
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IgG against desmosomes (anti-DSG-3 +/- anti-DSG-1)
Acantholysis Positive Nikolsky's sign |
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Bullous pemphigoid: what type of immunoglobulin against what?
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IgG against hemidesmosomes
Shows LINEAR immunofluorescence. See esosinophils within blisters Spares oral mucosa Negative nikolsky sign |
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Dermatitis hepatiformis: see Ig where?
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IgA deposits at the tips of the dermal papillae
Assoc w celiac disease |
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Lichen planus: histo? assoc w what disease?
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Histo is sawtooth infiltrate of lymphocytes at the dermal-epidermal junction
associated with HCV |
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Pityriasis rosea: assoc w what diseases? r/o what? txt?
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assoc w HHV-7
prodromal URI check RPR to rule out secondary syphilis! Can give erythromycin |
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What is a leukotriene that is a neutrophil chemotactic agent?
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LTB4
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Function of LTC4, D4, E4
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bronchoconstriction, vasoconstriction, contraction of smooth muscle and INC vascular permeability
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Prostacyclin (PGI2): function
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inhibits platelet aggregation and promotes vasodilation
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Prostaglandins (PGE2): function
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DEC vascular tone
INC pain INC uterine tone INC temperature |
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Aspirin: main function
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irreversibly binds cyclooxygenase by covalent binding, which dec the synthesis of prostaglandins and thromboxane
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Aspirin: main tox
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Acute renal failure/interstitial nephritis
GI upset Reye's syndrome Aspirin induced athsma (leukotriene receptor blockers (Zafirlukast, Montelukast) especially good for treating this.) |
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NSAIDs: MOA
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block prostaglandin synthesis (thereby blocking pain) by reversibly binding COX-1, COX-2
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Inhibiting COX-2 has what effects?
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Inhibits the synthesis of prostaglandins without inhibiting thromboxane.
COX-2 is found in inflammatory cells and vascular endothelium. |
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Acetaminophen: major tox?
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Hepatic necrosis!
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Bisphosphonates: MOA?
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Inhibit OCLs
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Drug for acute gout? MOA?
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colchicine. binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation.
Indomethacin also good for acute gout. Is a reversible inhibitor of COX. Dec prostaglandins, so DON'T use in renal failure (use sulindac instead - no renal toxicity) |
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Drugs to use in chronic gout?
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probenacid and allopurinol
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Etanercept: what does it do?
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TNF decoy receptor
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Infliximab: what does it do?
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Anti-TNF antibody. Best one for Crohn's
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Adalimumab: what does it do?
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Directly binds TNF-α sites
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Trendelenburg sign tests what muscles of the hip?
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The abductors: the gluteus medius and the gluteus minimus
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Estrogen therapy: how does it help to prevent osteoporosis?
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By inhibiting OCLs
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Psoas muscle: insertion
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Lesser trochanter of femur
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Gluteus maximus: insertion
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Gluteal tuberosity of femur
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Gluteus minimus, medius, piriformis: insertion
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Greater trochanter of the femur
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Anterior compartment of the leg: innervated by what? Action?
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The deep peroneal nerve
Dorsiflexes the foot |
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Lateral compartment of the leg: innervated by what? Action?
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Superficial peroneal nerve
Everts the ankle |
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Posterior compartment of the leg: innervated by what? Action?
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Tibial nerve
Plantarflexes and inverts foot |
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Most of the venous drainage of the lower limb goes through what vessel?
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The long saphenous vein
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Most of the lymphatics of the lower limb drain into where?
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Into the superficial group of the inguinal lymph nodes
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The lymph nodes draining into the popliteal fossa come from what area of the lower limb?
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From the lateral aspect of the foot --> lymphatics assoc w the short saphenous vein --> lymph nodes in the popliteal fossa
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