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Test your basic knowledge |
Musculoskeletal
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Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. precipitation of monosodium urate crystals into joints due to hyperuricemia
Degenerative injury due to repeated use - tiny tears in the tendons and muscles - may be inflammatory - lateral epicondyle is tennis - medial epicondyle is golf
Fever - fatigue - pleuritis - pericarditis
Fibrinoid necrosis surrounded by palisading histiocytes
Gout
2. Loss of what muslces in Erbs causes the limb to hang by side
Ewings sarcoma - aggressive with early mets - but responsive to chemo
Paralysis of abductors
ANA - sensitive but not specific
Allopurinaol - uricosurics (probenicid)
3. What do xray show in osteopetrosis and What do potential CN abnl result from
Erlenmeyer flask bones that flare out - narrowed foramina
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
Ulnar nerve - intrinsic muscles of hand
Adductor policis brevis
4. Other than N. gono - what organisms can cause infectious - septic arthritis
S. aureus - streptococcus
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
Loss of lateral lumbrical fxn - 2nd and 3d digits are clawed and can't extend
Type III - RF
5. What do palmar interosseous muscles do
Elevated ESR and nl CK - prednisone
Adduct the fingers
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit
Basophilic - rhomboid crystals - weakly birefringent
6. What nerve is injured in a fracutre of the hook of hamate
Elevated ESR and nl CK - prednisone
Ulnar nerve
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Acanthosis
7. Where do sebhorrheic keratosis lesions occur and in who
Intraepidermal bullae involving the skin and oral mucosa
Head - trunk - extremities - common benign neoplasm in older persons
4th and 5th finger
Keloid
8. What are the common perpetrating infections for Reiters syndrome
Post GI infxn or chlamydia
Median nerve - lunate bone
4th and 5th finger
Verrucae
9. inflammatory disorder affective synovial joints with pannus formation in joints
Rheumatoid arthritis
Osteochondroma - exostosis
Rigor mortis
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
10. What is the characteristic appearance of bone - the common translocation - area of - and bones affected
Femoral - thing flexion and leg extension - anterior thigh and medial leg
Ulnar nerve - fracture of hook of hamate
AP depol opens voltage gated Ca channels - inducing NT release
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
11. What lesion causes dec in thumb fxn 'ape hand'
Ulnar nerve - intrinsic muscles of hand
Chondrosarcoma
Median nerve
Hairy leukoplakia - HIV population - EBV mediated
12. What do the branches of the deep ulnar nerve innervate
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
Paralysis of abductors
Interossei and adductor policis
13. separation of epidermal cells
Acantholysis
Median nerve - same fingers but not on the hand
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
Squamous cell carcinoma
14. What autoantibodies are formed in sjogrens syndrome
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Ribonucleoprotein antigents - SS- A and SS- B (Ro and La)
Medial finger flexion - wrist flexion
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
15. What percent of these mutations occur sporadically and what parental feature are they associated with
Wire - loop lesions in kidney with immune complex deposition - death from renal failure and infxns
85% - advanced paternal age - or auto dominant inheritance
Scleroderma
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit
16. What form of polyostotic fibrous dysplasia has multiple unilateral bones lesions associated with endocrine abnl and unilateral pigmented skin lesions - caf
Strawberry hemangioma
Tibial - foot inversioon and plantarflexion; toe flexion - sole of foot is sensory
Asymmetric - swollen - red - painful joint - often MTP (podagra) - tophus formation on external ear - olecranon bursa - achilles tendon
McCune - Albright syndrome
17. What does ATP do in skeletal muscle contraction
Radial nerve
Sarcoidosis - black females - ACE
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Corneum - lucidum - granulosum - spinosum - basalis
18. What are the causes of inferior trunk plexus compression and What are the findings
Restrictive lung disease - bilateral hilar lymphadenopathy - erythema nodosum - Bell's palsy
Head - trunk - extremities - common benign neoplasm in older persons
Embryologic - childbirth defect - cervical rib compression - atrophy of the thenar and hypothenar eminences - atrophy of interosseous muscles - sensory deficits of the medial side of the forearm and hand - disappearance of the radial pulse upon movin
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
19. What receptor is constitutively activated in achondroplasia and What does it do
Impetigo - s aureus - s pyogenes
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Ephelis
AP depol opens voltage gated Ca channels - inducing NT release
20. Reduction of primarily trabecular (spongy) bone mass despite nl bone mineralization lab values
GC and cGMP and inhibition of MLCK
Dec Ca - dec phos - nl alk phos - inc PTH - soft bones
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Osteoporosis
21. What does the positive anterior drawer sign test indicate
Median nerve - same fingers but not on the hand
MCL - ACL - lateral meniscus (esp in athletes)
Tear of the ACL
Parotid enlargement - inc risk of B cell lymphoma - dental caries
22. What cancer in particular are associated with LE syndrome - what happens to symptoms with muscle use or ACH esterase inhibs
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Type 1 - inc mitochondria and myoglobin conc - inc OXPHOS leading to sustained conctraction
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
Pemphigus vulgaris
23. What is the tumor marker for melanoma - who is at risk - what correlates with risk of metastasis and What is the gross path
NSAIDs (indomethacin) colchicine
S100 - associated with sunligh exposure - fair skinned at risk - depth of tumor correlates with risk of mets - dark with irregular borders
Erlenmeyer flask bones that flare out - narrowed foramina
Patch
24. Where are most osteoid osteoma found and In what population
Myosin releases bound ADP and is displaced on the actin filament
Impetigo - s aureus - s pyogenes
Lung
< 2mc found in proximal tibia and femur - men < 25
25. In smooth muscle contraction - What does Ca bind and What is the purpose
Infraspinatus - laterally rotates arm
3rd finger
Polymyositis - shoulders - perifasicular inflammation
Calmodulin - complex activates myosin light chain kinase
26. dactylitis and pencil in cup deformity on xray - patchy skin rash and joint pain
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Squamous cell carcinoma
Phosphorylates myosin light chain which leads to cross bridge formation
Connects cells to underlying extracellular - bullous pemphigoid
27. In which joints does pseudogout typically occur
Large goints (knee)
Increase in both osteoblast and osteoclast activity
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Corneum - lucidum - granulosum - spinosum - basalis
28. What lesion causes winged scapula
Axilla
Nevocellular nevus
Long thoracic nerve
Serum ca - phos - alk phos are NL
29. Tumor occuring mostly at epiphyseal end of long bones - occuring btw 20 and 40 - locally aggressive bening tumor around distal femur and proximal tibia - tumor and characteristic xray findings
Mosiac bone pattern - long bone chalk stick fractures - increased hat size or hearing loss due to auditory foramen narrowing
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Axillary nerve
Osteoarthritis
30. papules and plaques with silvery scaling - especially on knees and elbows - acanthosis with parakeratotic scaling (nuclei sill in stratun corneum - nail pitting and arthritis
Elevated ESR and nl CK - prednisone
Psoriasis
Anti - histone
NSAIDs (indomethacin) colchicine
31. How does the radial nerve in the spiral groove become injured
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Ischial spine - relieve pain during delivery
Lesioned by midshaft fracture of humerus
Phosphate is liberated from the myosin head
32. What are the lab findings in pagets disease
Inc alk phos - abnl bone architecture
Fever - fatigue - pleuritis - pericarditis
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages
Upper trunk of brachial plexus
33. What is a very specific test for lupus
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Anti ds DNA - poor prognosis
Type III - RF
Dec Ca - dec phos - nl alk phos - inc PTH - soft bones
34. What lesion causes difficulty flexing elbow with variable sensory loss
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
Axillary nerve
Nevocellular nevus
Musculocutaneous
35. What kind of jxn is the zona occludens andw What is is composed of...
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
Crohns and ulcerative colitis
Actinic keratosis - risk proportional to epithelial dysplasia
Median nerve - same fingers but not on the hand
36. Patients with pagets disease can develop what cancer
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Osteogenic carcinoma
ANA - sensitive but not specific
Gout
37. chronic inflammatory disease of sacroiliac joints and spine - dz - associations
TB from dissemination and lyme dz
Wire - loop lesions in kidney with immune complex deposition - death from renal failure and infxns
Type III - RF
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
38. Where does squamous cell carcinoma of the skin typically appear - What is the histo - prognosis - and associations
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Phosphate is liberated from the myosin head
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
The dermis
39. What nerve is compressed by supracondylar fracture of humerus
Median nerve
Dysplastic nevus
Making fist with a proximal median nerve lesion
Median - lateral finger and wrist flexion - dorsal palmar aspects of lateral 3.5 fingers/thenar eminence - ape hand - carpal tunnel syndrome
40. epi of SLE
Age - obesity and joint deformity
Teres minor
Female between 14 and 45 - mostly black
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
41. What is the landmark for an LP
Verrucae vulgaris
Hyperkeratosis
Iliac crest
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
42. What causes osteoporosis type 1 and When does it typically occur
Crust
Atopic dermatitis - eczema
Dec estrogen causes inc bone resorption - postmenopausal
Axillary nerve
43. inflammatory lesions of subQ fat - usually on anterior shins - associated with coccidioidomycosis - histoplasmosis - TB - leprosy - streptoccocal infxn - sarcoid
Condyloma acuminatum - caused by HPV
Median nerve
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Erythema nodosum
44. What enzyme is necessary for smooth muscle relaxation after contraction
Abduct the fingers
Myosin light chain phosphotase
Macule
Inc blood flow from AV shunts can cause high output heart failure
45. What lesion causes deltoid paralysis
Axillary nerve
S. aureus - streptococcus
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
Staph scalded skin syndrome
46. progressive symmetric proximal muscle weakness cause by CD8+ T cell induced injury to myofibers - dz - most common area of involvement and pathgnomonic histological finding
Obturator - thigh adduction - medial thigh
Polymyositis - shoulders - perifasicular inflammation
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
47. What is the defect in Paget's disease
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Increase in both osteoblast and osteoclast activity
Biceps
Radial nerve
48. What causes the symptoms of MG to worsen - and What is used to diagnose
Fever - fatigue - pleuritis - pericarditis
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Teres minor
Muslce use - nerve stim/compound muscle test
49. What syndrome of the NMJ is a paraneoplastic syndrome and What are the antibodies directed against
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
Actinic keratosis - risk proportional to epithelial dysplasia
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
Radial nerve becomes compressed in axilla
50. pelvic fracture can cause injury to which nerve - and What are the motor and sens def
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
Femoral - thing flexion and leg extension - anterior thigh and medial leg
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Parakeratosis
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