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282 Cards in this Set
- Front
- Back
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What help the bones of children to not fracture easily leading to buckle fracture and greenstick fracture ? |
They have periosteum lining their bone |
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What is mcmurray test ? |
Pain or popping while external (medial meniscal tear)or internal rotation ( lateral meniscal)of knee |
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Medial mensical injury accompany injury of what ligament usually |
Medial ligament due to twisting i jury |
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Differnce in tension in greenatick and torus |
Greenstick (bone fail at tension side and intact in compression side) Torus ( tension remain intact) |
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Prepatellar bursitis and infrapatellar bursitis associated with what occupation? |
Mechanics / plumbers , carpet layers |
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Ansirine bursitis along medial knee |
Obese or atheltes |
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Suprapatellar bursa location |
Btw distal femur and quadriceps |
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Suprapatellar bursa in who |
Runners |
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Trochantric bursitis |
Pain on lateral hip or thigh ( pain increase when lying on the side or by walking) |
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Musclea abduct below horizental line |
Supraspinatus Deltoid |
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Muscles abduct above horizantal line |
Trapezius Serratus anterior |
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What cause nursmaid elbow |
Radial head sublaxation due to tear in annular ligament. |
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Presentation of nursemaid elbow |
Extended elbow Pronated forearm Arm held close to body |
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Pts with medial epicondilitis will have diffculty what |
Flexion |
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Pts with lateral epicondilitis will have diffculty what |
Extension ( site extensor carpi radialis brevis insertion) |
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Is it true inflammation in epicondylitis ? |
No , it is called angiofibroblastic tendonitis ( due to increase fibroblast and neovasculrization) |
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Feeling tenderness in anatomical snuffbox |
Scaphoid fracture |
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What is the other name for flexor retinaculum |
Transverse carpal ligament |
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What forms guyon canal |
Pisiform Hool of hamate Pisohamate ligament |
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Fracture of 5th metacarpal neck |
Boxer fracture ( commonly infected by ekinella) |
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What border anatomical snufbox |
Medially (extensor pollices ) Lateraly ( extensor pollices brevis) Floor ( scaphoid and trapezium) |
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Axillary nerve commonly runs through what ? |
Quadragranular space (bordered lateraly by humerus and medially by long jead of triceps and inferiorly by teres major and superiorly by teres minor) and surgical neck of humerus |
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What DTR can be lost in musculicutanous nerve injury ? |
Biceps |
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Pts with decrease triceps reflex usually have injury to what |
Radial nerve |
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Fingerdrop of thumb due to what |
Sublaxation of radial head usully in pts who do pronation and suponation alot ( using screwdriver) Lead to injury of deep branch of radial nerve |
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Suprachondylar fractur anteriomedially injur what |
Median nerve |
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Suprachondylar fracture laterally injure what ? |
Radial nerve |
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Suprachondylar fracture with posterior dislocation |
Unlar nerve damage |
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Falling on flexed elbow usually injure what |
Ulnar nerve |
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Brachial plexus control all of the upper extrimity except what muscle |
Trapezius ( accessory nerve) |
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Nerves injured in erbs palsy ? |
Musculocutanous Suprascapular |
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TOS most commonly occur where |
Scalene triangle |
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Abnormal insertion or spasm of scalene muscle lead to what |
TOS |
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How fractured clavicle can lead to TOS |
Subclavian vein thrombosis lead to PE |
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What is cervical rib |
Cartelegnous elongation of 7th rib |
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What cause pain in TOS |
Subclavian A compression |
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What lead to edema in TOS |
Subclavian vein compressio |
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Pt cant abduct shoulder above horizantal line , how to know if it due to long thoracic nerve or accessory nerve injury |
If scapula winging ( long thoracic) If there shoulder drop( accessory, long thoracic dont cause shoulder drop ) |
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What happen in radial pulse when moving head to opposite side in TOS ? |
Diminshed radial pulse |
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Injury to both median and ulnar nerves lead to what ? |
Simian hand |
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Palpable mass in mid upper arm , what to think |
Biceps tendon rupture |
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What common injury occur in baseball playrrs and tt |
Ulnar collateral ligament injury ( strengthen ulnohumeraljoint)
Tt tomy john surgery
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Clavicular fracture direction of proximal and distal segments |
Proximal ( upward by SCM) Distal ( downward by pectoralis major) |
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What supply latismuss dorsi and funxn |
Thoracodorsal nerve it leads to shoulder (extension,Adduction,Internal rotation) |
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The only nerve course through obturator canal |
Obturator nerve |
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What type of pelvic surgery can lead to obturator nerve injury |
Prostatectomy Bladder ca |
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Loss of sensation of anterior thigh of knee reflex loss ? |
Femoral nerve injury |
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What nerve pass deep to midpoint of inguinal canal to reach thigh ? |
Femoral N. |
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Abcess or hematoma of paoas major can compress what nerve ? |
Femoral nerve |
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Injury due to superficial peroneal nerve |
Loss of eversion and loss of dorsum of foot sensation |
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Injury due to deep peroneal nerve |
Drop foot Loss of sensation btw 1st and 2nd toes |
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Tarsal tunnel syndrome symptoms |
Tibial nerve injury Lead ONLY to sensory loss over the sole of foot ( no motor problems) |
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Knee trauma to popletial foss lead to injury of what ? |
Tibial nerve injury |
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Pts with tibial nerve injury cant curl their toes , what muscles lead to this function |
Flexor digitorum longus Flexor hallicus longus |
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Trendelburg sign seen where |
Fracture of femoral neck Hip disloction . Gluteus medius paralysis ( superior gluteal nerve) |
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Best site for intamuscular injection |
Von hochester triangle ( superolateral quadrent , on the lateral side ) |
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If intramuscular injection applied in superiomedial quadrant , what injury would result ? |
Superior gluteal nerve injury ( gluteus medius paralysis) |
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If intramuscular inection applied in site other than superior medial or superiolateral , what nerve injury would result |
Sciatic nerve |
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What nerve exit through great sciatic foramen above the piriformis ? |
Superior gluteal nerve |
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What nerve exit through greter sciatic foramen and below piriformis ? |
Inferior gluteal nerve |
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What nerve exit through great sciatic foramen btw piriformis and coccygeus muscle ? |
Sciatic nerve |
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Shat land mark do we use in pudendal nerve block ? |
Ischeal spine |
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Muscle leave through lesser sciatic foramen |
Obturator |
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Fan shaped muscle |
Obturator |
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Muscle that work externaly rotate the thigh when extended and abduct when thigh flexed ? |
Piriformis |
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Muscle we use to sit up from supine position |
Rectus abdominus Abdominal oblique Hip flexors ( mostly illiopsoas) |
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Most common injured ligament in LOW ankle sprain ( WHILE PLANTARFLEXED WITH INVERSION) |
Anterior talofibular ligament |
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Most common high ankle sprain ligament injury( while dorsiflexion) |
Anterior inferior tibiofibular |
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Forced eversion of foot lead to what injury |
Dupyturyn fracture (most commonly avulsion fracture of medial malleolus, injury to deltoid ligament , lower end of fibula ) |
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Piriformis syndrome ( hypertrophy of priformis ) affect what nerve ? |
Sciatic nerve ( pain and tingling in buttocks and thighs) |
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Intrabdominal infection can spread to what muscle lead to formation of abcess in it ? |
Psoas muscle |
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Pts with psoas abcess have what ? |
Hip flexion Lordosis +ve psoas sign ( pain with hip extension) |
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L2 RADICULOTPATHY |
Sensory loss on upper anteriomedial thigh No hip flexion ( illiopsoas) |
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L3 RADICULOTPATHY |
Sensory loss ( anteriomedial thigh) No hip flexion or knee extension |
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L4 RADICULOTPATHY |
Sensory loss anterioltaeral thigh Loss of knee reflex No knee extension or hip extension ( gluteus maximus) |
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L5 RADICULOTPATHY |
Sensation loss on posterior thigh, buttcks and dorsal foot No foot dorsiflexion ( tibilis anterior) No Foot eversion ( proneus) No Toe dorsiflexion |
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S1 RADICULOTPATHY |
Loss of achillis reflex Lossof sensation of posterior thigh , buttocks , lateral side of foot No hip extension ( gluteus maximus) No knee flexion ( hamstring) No plantar flexion ( gastronemeus) |
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How to differ btw conus medullaris(L2) syndrome and cauda equina (S2-S4)? |
Cauda equina has loss of anorectal reflex |
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Patellar fracture presntaion |
Can extend knee , swelling in knee |
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Things that lead to patellar fracture |
Landing on feet after falling ( due to injur of quadrecips muscle that insert in tibial tuborsity) |
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Function of T tubules ? |
Coordinated contraction of muscles |
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Decreased T tubules seen where ? |
Limb girdle muscular dystrophy |
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Limb gridle dystrophy occur due to what |
Cavolin mutation ( low T tubules) .. Uncoordinated contraction |
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Binding of new ATP at the end of contraction lead to detachment of myosin head, if not present , what will happen |
Sustained contraction ( rigor mortis) |
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What lead to relaxation of muscle? |
Increase sacroplasmic reticulum Ca++ and low intracellular Ca++ |
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LOOK FOR MUSCLE SACROMERE CONTACTION AND LINES ( Z, I, M.....) |
****** |
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Postural muscles ( paraspinal muscles , soleus...) contain what muscle fiber type ? |
Type 1 They contain low glycogen |
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Type 2 muscles have high or low glycogen |
High glycogen |
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Proprioceptors systems of muscle |
Spindle muscle system Golgi tendon organ |
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Function of spindle muscle system |
It sense the strech and the speed of strech so when you strech muscle to the endpoint your spindle muscle system sense that and send signals to spinal cord to stop streching . |
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Function of golgi organ tendon |
Sense tension on muscle , so when you try to left overweight , if you you are exerting to much tension on muscle , golgi tendon will relax the muscle ) |
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Source of NO that lead to smooth muscle relaxation ? |
Arginine |
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Other name of lamellar bone |
Compact bone |
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Which type of bone cells is mononuclear |
Osteoblast, while osteoclast is multinuclear |
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What we use to measure osteoblast activity ? |
-ALP -OSTEOCALCIN -PROPEPTIDE OF TYPE 1 PROCOLAGEN |
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Osteoblast secrete collagen and lead to minerlizatiin how |
In alkaline envirmoent via ALP |
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How exactly low estrogen lead to osteoprosis ? |
Estrogen increase osteoprtogein bind to RANK receptor prevent mononuclear osteoclast to diferentiate into multinuclear osteoclast . Thats why when have low estrogen , means higher osteoclast maturation |
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What is the role of FGFR3 mutation in achondroplasia ? |
Inhibit chondrocyte proliferation |
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Increased paternal age associated with what ? |
Achondroplasia |
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Achondroplasia is autosomal dominat that show ------- and if was homozygous it will be ------- |
Full penetrance Lethal |
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Osteoprosis show loss in what fype of bone |
Trabecular( spongy) and cortical bone |
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What is the most common site of fracture in osteoprosis ? |
Vertebral bodies Then Neck of femur |
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Drugs can lead to osteoprosis |
Steroids Heparin PPI GnRH agonist Anticonvulsant ( phenytoin / phenobarbital/ carbamezapine) Thyroid replacment therapy |
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African american have ---- bone density and ------- risk of fracture |
High Low |
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Charastarestic finding in osteopetrosis ? |
Persistance of 1°unmenarlized spongiosa in medullary canals |
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Process where woven immature bone convert to compact bone is what in osteopetrosis ?? |
Disrubted |
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Pts with carbonic anhydrase can have what renal problem ? |
RTA |
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Histological mark of ricktes or ostemalacia ? |
Defective menralization of osteoi . With accumlation around trabeculea |
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What seen in rickets on xray |
Epiphyseal cupping or fraying |
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Osteocytes within lacune in chaotic juxtapositions seen wheere |
Paget disease |
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Paget disease associated with what heart condition early in disease |
High output heart failure |
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What is specific for osteoclasts in paget disease |
Osteoclast normaly have 2- 5 nuclei , while in paget they can have up to 100 nuclei |
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Paget disease tt ? |
Bisphosphonate |
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AVN of tibial tubercle seen where ? |
Osgood schlatter |
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AVN presentation |
Only decrease ROM with pain no erythema or swelling |
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What artery is very important in children and aupply femoral head proximal to epiphuseal plate ? |
Artery of ligmantum teres ( brancg of obturator) |
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In pagrt disease , in what phase the mosaic pattern will form? |
PHase III |
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Osteoma ? |
Facial bone ( gardner synd.) |
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Osteoid osteoma ? |
Bone pain resolves with aspirin Arise from bone cortex |
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Osteochondroma site ? |
Metaphysis of long bone |
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Familial retinoblastoma associated with which bone Ca ? |
Osteosarcoma( osteogenic sarcoma) |
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Bx of osteogenic sarcoma show ? |
Cells produce osteoid |
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Ewing sarcoma can be confused with what |
Chronic osteomylitis and lymphoma ( they present with high fever) |
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Translocation 11:22 lead to what protein |
EWS-FLI1 |
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What bone ca arise from medulla of hands and feets |
Chondroma |
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What bone ca arise from medulla of pelvis and caudal skeleton ? |
Chondrosarcoma |
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What type of infection arise from metaphysis |
Osteomyelitis |
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First joint usually affected in osteoarthritis |
1st CMC |
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What are the cause of anti-CCP in RA ? |
Tissue inflammation in rheumatoid arthritis lead to arginine residues like (vemintine) to convert to citrulline in a process called citrulation .change in shape detected as antigens by antibodies |
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Joints that are spared in RA ? |
DIP 1st CMC |
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Stifness in RA last for how long |
More than 1 h |
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Pt with RA satrted on hydroxychloroquine , how to monitor ? |
Opthalmoscope ( retinopathy risk) |
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What is the 1st line tt in RA ? |
Steroids and NSAIDs ( rapid effect) We use them until DMARDs take effect |
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Fibrinoid necrosis with pallisading histocytes in subQ tissue , result from what ? |
RA |
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What is felty syndrome |
Rheumatoid arthritis + neutropenia + splenomegaly |
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What type of cells play a role in gout |
Neutrophills |
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Gout occur with rich purine food like: |
Seafood Red meat |
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DOC IN GOUT |
NSAID ( indomethacin) , If contraindicated Steroid or cholchicine |
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Can we use allopurinol / febuxostat in gout ? |
NO , ONLY PREVENTION ( CHRONIC) |
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How to treat acutly pseudogout ? |
NSAIDS STEROIDS COLCHICINE |
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How to PREVENT pseudogout |
Cholchicine |
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Sjogren affect what type of glands ? |
Exocrine glands especially lacrimal and salivary |
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Anti SSA can be seen with other disease , and if was positive in pregnant women it will give indication of what ? |
In SLE if in pregnant ( higher risk of congenital heart block) |
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How to diagnose Sjogren's syndrome |
Labial salivary gland biopsy |
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Septic arthritis wbc synovial |
WBC >50,000 |
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Synovial WBC in RA and osteoarthritis |
OSTEOARHTRITS( <2000) RA (2000-50,000) |
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What is juvinile idiopathic arthritis ? |
In children <12 yo Spiking fever . Salmon pink macular rash Arthritis >2 joints Thrombocytosis, high ESR Tt : Nsaids , steroid, MTX |
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JIA vs Leukemia |
JIA ( THROMBOCYTOSIS) LEUKEMIA ( HIGH LDH) |
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Enthesitis ( pain on tendon insertion) seen where |
Seronegative spondyloarthropathies |
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How to monitor progression of pts with Ankylosing ? |
By measuring chest expansion ( costovertebral and costosternal ankylosis leading to limited chest expansion) |
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Keratoderma belnnorhagicm seen where ? |
Reactive arthritis |
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Reactive arthritis seen after how long after urethritis or entritis ? |
1-4 wks |
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Cause of clinical manifestations in reactive arthritis |
Immune complexes |
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Joint aspiration of reactive arthritis ? |
Sterile |
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Sacroilliac joint and spine involvment lead to fusion seen in |
Ankylosing spondylitis |
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Drug induced lupus |
Hydralazine procainamide isoniazid quinidine Minocycline |
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Antiphospholipid antibodies |
Anticardiolipin B2 glycoprotein ABs |
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Anticardiolipin antibodies lead to what ? |
VDRL/RPR +ve Prolonged PTT |
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Mixed connective tissue disease anti bodies |
Anti-U1 RNP |
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What are ANTI U1 RNP ? |
Speckled ANA |
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Neonatal lupus antibodies ? |
Anti-Ro abs |
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A very important finding in sarcoidosis to differ from other interstitial disease |
increased CD4+/CD8+ ratio |
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Shaumann bodies Asteroid bodies ? |
Shwumann ( calcification) Asteroid ( stelliate giant cell) |
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How to dx fibromyalgia ? |
Fatigue more than 3 m without any findings |
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Cause of fibromyalgia ? |
Abnormal Central processing of painful stimuli |
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Cause of endomysial inflammation with CD8+ in polymyositis ? |
MhC I overexpression on sacrolemma |
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Specefic abs of polymoyositis/ dermatomytosis |
AntiSRP abs AntiMi2 abs |
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Tt of polymyositis and dermatomyositis |
Steroids followd by Longterm MTX |
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Antihysidyl tRNA synthase abs are ? |
Anti-jo-1 |
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Polymyositis histology ? |
Perimysial inflammation and atrophy |
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Cells involved in polymyositis and dermatomyositis |
Polymyoaitis ( CD8+) Dermatomyosiits ( CD4+) |
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Dermatomyoaitis , youl should look for ? |
Occult malignancy like ovarian, lung or gastric cancer or colorectal cancer |
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How to differ btw lambert eaton and MG |
Lambert Eaton patients improve with muscle use while MG worse Lambert eaton show dec. DTR while MG not |
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Raynaud phenomenon |
Small vessels spasm due to cold or stress |
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Raynaud phenomen color change |
White ( ischema) To Blue ( hypoxia) To Red ( reperfusion) |
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Raynaud syndrome vs raynaud disease |
Raynaud syndrome ( when come with connectibe tissue disease) Raynaud diseas (when come alone) |
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Raynaud syndrome can have what ine fingers |
Ulcdration due to ischemea |
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Raynaud tt |
CCB |
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Pt with MG and on pyredostigmine , and start to have symptom worsening what to do next |
Do edrophnium test. If improved (Treating dose wasnt enough) If no improvment ( pt is having cholenergic crisis and pyredostigmine should be stopped) |
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Skin layers from surface to base |
Stratum corneum Lucidum Granulosum Spinosum Basale |
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Stem cells presnt in which layer of skin |
Stratum basale |
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Keratin presentnin which layer of skin |
Keratin |
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Desmosomes presnt in which skin layer |
Startum spinosum |
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Stratum lucidum present only where ? |
Palmar or plantar |
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Tight junctions present where |
Stratum granulosum |
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Tight junctions function and composed of what |
Prevent paracelular movment Contain claudins ( target of c.diff) And occludins |
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Adherense junctio ( aka belt desmosome or zonula adherens ) |
Conncect actin with cadherins Loss of cadherins >>mets |
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Desomosmes ( aka spot desmosome , macula adherens) |
Support ( intermediate filaments) Contain cadherins ( desmoplakina and deamoglien) |
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Gap junctions ( aka connexons) |
Permit elictrical and chemical communication |
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Hemidesmosomes |
Contain integrin Connect keratin in basal layer to BM |
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Integrins |
Bind collagen and laminin and fibronectin and actin in BM Unlike others It binds to actin INRACELLULARY |
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What are cellular anchors |
Desmosomes hemidesmosomes adherens Junction |
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What is hypergranulosis |
Thickness of stratum granulosum like in lichen planus |
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What is dyskeratosis, give example |
Premature keratinization of keratinocytes below stratum granulosum . SCC or dyskeratosis congenita ( genitc mutation) |
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What is postinflammatory hypopigmentation |
Redistribution of existing melanin and resuced transfer of melanin to keratinocytes |
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Cafe au lait spot cause ? |
Increase melasome aggregates within melanocyte |
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Side effects of applying steroids for long periods on skin like in eczema pts?? |
Decreased extracellular Matrix collagen and GAGs production, leading to (atrophy of dermis ,drying, cracking and skin tightening) |
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Atopic dermatitis cant be diagnosed without this symptom |
Intense pruritis |
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Acne stages |
-Follicular hyperproliferation and keratin block sebum . -excessive sebum production. - inflammation . -Propionobacterium acne . -bacterial hydrolysis of TGA and release of FFA |
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Propionobacterium acne now called what |
Cutibacterium acne |
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Comedons |
Propionobacterium pilosebceous glands colonization |
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Acne tt |
Retinoids Benzoyl peroxidas Abx |
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Mutation in what predispose atopic eczema ? |
Fillaggrin ( skin barrier dysfunction) |
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If atopic eczema was not treated what will the biopsy will show |
Intraepidermal vesicles hyperkeratosis epidermal hyperplasia |
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Bx of contact dermatitis |
Spongiosus and lymphocytic perivascular infiltrate |
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Junctional nevi are limited to what |
Dermoepidermal junction |
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Does intraepidemal nevi produce pigment |
No ( tyrosine lost) |
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Pseudofolliculitis barbae |
Occur after shaving . |
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Where do we see munro microabcess ? |
Psoriasis ( neutrophills collection in stratum corneum) |
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Main type of cells in psoriasis ? |
CD4+ Tcells |
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Acanthosis and mitotic activity above epidermal basal lyer |
In psoriasis |
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Rosacea ? |
Commonly lead to rhinphyemea They lack comedons Alcohol or heat perciptate it |
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Histology of seborrhic hyperkeratosis ? |
Keratin pseudocyst |
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Urtecaria |
Superficial dermal edema and lymph dilatation |
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What things lead to IgE independent degranulation ? |
Opioids radio contrast Vancomycin |
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Mast cell independent urticaria |
Aspirin Hereditry angineurotic edema |
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Angiosarcoma of liver associations |
Radiation therapy post-mastectomy lymphedema Vinyl chloride arsenic |
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Bacillary angiomatosis vs kaposi? |
Bacillary has neutrophillic infiltrate while kaposi has lymphocytic |
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Cherry hemangioma regression |
Dont regress |
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Strawberry hemangioma regression |
Grows rapidly and regress by 5 to 8 years |
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Cavernous hemangioma |
Manily in dermis If in Brain ( VHL) |
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Glomus tumor |
Painful blue tumor under nails . Arise from smooth muscle thermoregulatory glomus body . |
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Glomus tumor DDx |
Subungual melanoma |
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Pts with skin scalded syndrome in adults when |
Renal insuffeciency |
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SSSS show what sign |
Positive nikolasky sign |
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Diff btw pemphigus and pemhigoid |
Pemphigus ( intraepithelial cleavage) Pemphgoid ( subepidermal cleavage) ------ Pephigus ( bullea rupture easily) Pemphigoid (( hard bullae) ------ Pemphigus ( affect oral mucosa) Pemphigoid ( spare oral mucosa) ------ Pemphigus ( netlike pattern) Pemphigoid ( linear pattern) |
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Bullae spread laterally with pressure is with what ? |
Pemphigus ( asboe hansen sign) |
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Tt of dermatitis herptiformis? |
Dapsone |
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Target lesions |
Erythema multiforme SJS |
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Necrotic keratinocyte in epidermis |
SJS |
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Antibodies against skin BM proteins seen in ? |
Epidermolysis bullosa acquista Cicatricial pemphigoid |
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Connexinn defcets seen in |
Palmoplantar keratoderma Deafness associated icothysis |
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Collarette scales seen in ? |
Pytriasis rosea |
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Pytriasis rosea course ? |
Self resolving ( 6-8wks) |
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Erythema nodsum cells |
Neutrophillic and giant cell infiltration |
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Erythema nodsum histopathlogy |
Widening of connective tissue |
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Hyperkeratosis leading to cutanous horns |
Actinic keratosis |
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what lead to overactivation of BRAF in melanoma ? |
NRAS independent way |
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Malignant behavior of melanoma related to expression of what |
Integrins |
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What would improve the prognosis of melanoma |
Presence of lymphocytic infiltration |
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Melanoma commonly metastasizes to where |
CNS leading to seizures |
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How does aspirin inhibit COX |
Covalent acytelation |
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Shortly after startimg colchicine pt can develop what ? |
Diarrhea |
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Avoid colchicine in ? |
Renal failure |
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We use NSAIDs in acute gout tt but never use salicylates , why ?? |
Decrease uric acid secretion espwcially at low doses |
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Probencid contraindicated in ? |
Renal stones Hx |
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Teriparatide Moa |
Recombimant PTH ( increase osteoblast activity |
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Teriparatide use |
Osteoprosis ( they cause bone growth , while bisphosphonate prevent bone loss only) |
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Teriparatide SE ? |
Increase osteosarcoma ( avoid in paget disease pt or pt prior Ca or radiation therapy) |
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Which drug in gout tt consodered as uricosuric ? |
Probenecid |
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Acute compartment syndrome usually occur where ? |
Anterior compartment ( anterior tibial A, deep peroneal nerve "foot drop", foot extensor muscles, ) |
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Posterior Compartment syndrome contain what nerve ? |
Tibial |
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Lateral Compartment syndrome contain what nerve ? |
Superficial peroneal Nerve and proximal part of deep peroneal ) |
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Osgood schlatter occur why ? |
Overuse of apophysis ( 2° ossification center) of tibial tubercle . Occur commonly due to jumping in children |
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Where do we do the femoral nerve block ? |
At the inguinal crease . Femoral nerve is lateral to inguinal canal and not accessible there |
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Osteocyte connect to each other via |
Gap junctions |
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Things that reflects osteoclastic activity ? |
Taratrate phosphatase Urinary hydroxyproline Urinary deoxypyridine |
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B cell activating factor def and excess |
BAFF DEF ( IMMUNODEF.) BAFF EXCESS ( SLE) |
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Types of glands |
Merocrine ( secrete via exocytosis, like salivary ,) Apocrine ( secrete via merbrone bound vesicles , like mammary glands) Holocrine ( cell lysis , like sebacous and mebomian ) |
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What sense the stress in bone and what is the response |
Osteocyte , leading ro osteoblast actvation ( remodelling) |
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How osteoblast promote minerlization |
Secrete osteocalcin and phosphatase |
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What muscle is the most important in achieving intraabdominal and intrathoracic pressure |
Rectus abdominus |
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Cause of neurogenic claudication in degenrative arthritis |
Due to vertbral disc degnration ( leading to ligmantum flavum hypertrophy ) |
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Differ btw ephlides and solar lentigines ? |
Ephlides ( increase melanin production) Solar lentigens ( increase prolifratiom of melanocyte themsleves) |
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Alopecia areata tt |
Steroids |
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Vit D can be used to tt what skin condition ? |
Psoriasis ( decrease keratinocyte proliferation and differntiation) |
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Why gout usually appear after trauma history ? |
Normaly urate crystals are coated with apolipoprotein E or B , so when trauma occur it will expose them to IgG leading to release of IL-1( infiltration of neutrophil and macrophages ) |
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What will mollacosum conatgoisum show on bx ? |
Eosinophillic cytoplasmic inclusions |
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Most common injured structure in knee posterior and anterior dislocation is what ? |
Popliteal artery which is fixed to adductor magnus and soleus muscles ( not tibial nerve ) |
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Contributors of osteoarthritis ? |
Excessive biochemical stress and increased metalloprotease activity |
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What is callus ? |
Area of repeated friction lead to thikening in skin due to thickening of stratum corneum |
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What is the name of cells that have a role in both destruction and repair in osteoarthritis ? |
Chondrocytes |
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Manifistations if systemic juvenile idiopathic arthritis ? |
- Reccurent and relapsing spiking fever - salmon pink rash - polyarticular joint pain - macrophages start to digest RBC ( in about 30-50% of pts ) - anterior uveitis Tt: steroids /MTX /IVIG |
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Which antifungal lead to testrone inhibtion and to hyperpigmentation of skin ? |
Ketoconazole |
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What is Iliotibial band syndrome |
Pain on lateral knee due to overuse in runners |
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What is medial tibial stress ( AkA shin splints ) ? |
Bone resorption that outpaces bone formation in tibial cortex In runners and military recruits |
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What defines compartment syndrome ? |
Pressure gradient btw compartment and diastolic BP is <30 |
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Heel pain that is worse during first steps in morning ? |
Plantar fasciitis |
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What is dequervian tenosynovitis ? |
Noninflmmatory thickineing of abductor pollicis longus and extensor pollicis brevis . They have +ve finkelstein test |
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What is Ganglion cyst ? |
Fluid filled swelling arise from dense connective tissue herniation |
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What is DDH ? |
Abnormal acetabulum development . Xray done 4-6 months until cartilage is calcified |
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Leg calve perthes ? |
AVN of femoral head in children 5-7 y.o |
