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Test your basic knowledge |
Musculoskeletal
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
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. Where does cartilage loss begin in osteoarthritis
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages
McCune - Albright syndrome
Xeropthalmia - xerostomia - arthritis
Medial aspect
2. appreas in 30s to 40s - does not regress
Cherry hemangioma
Increase in both osteoblast and osteoclast activity
Strawberry hemangioma
Radial nerve
3. What lesion causes wrist drop
Ribonucleoprotein antigents - SS- A and SS- B (Ro and La)
Men and women > 70 - senile osteporosis
Posterior cord
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
4. Pain and stiffness in shoulders and hips - fever malaise and weight loss - no weakness - pts over 50 - associated with HA and jaw pain
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Pseudogout
Keratoacanthoma
Phosphate is liberated from the myosin head
5. What does PED and Tip stand for
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6. What percent of these mutations occur sporadically and what parental feature are they associated with
MCP - PIP - no DIP
85% - advanced paternal age - or auto dominant inheritance
Inc alk phos - abnl bone architecture
Upper trunk of brachial plexus
7. Where do sebhorrheic keratosis lesions occur and in who
Hairy leukoplakia - HIV population - EBV mediated
Head - trunk - extremities - common benign neoplasm in older persons
Anti ds DNA - poor prognosis
Phosphorylates myosin light chain which leads to cross bridge formation
8. Damage to what 3 structures is common for the unhappy triad
MCL - ACL - lateral meniscus (esp in athletes)
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
NSAIDs (indomethacin) colchicine
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
9. Trauma to lateral aspect of leg or fibula neck fracture - nerve - motor and sens def
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
MCP - PIP - no DIP
10. Besides the skin - what other organ systems are commonly affected by scleroderma and who is primarily affected
Renal - pulm - CV - GI - 75% female
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Squamous cell carcinoma
Verrucae vulgaris
11. What supplies innervation to the thenar muscles
S. aureus - streptococcus
Melasma (chloasma)
Iliac crest
Recurrent branch of the median nerve
12. What lesion causes total claw (klumpke's hand)
Lower trunk of brachial plexus
Type 2
Fibrinoid necrosis surrounded by palisading histiocytes
Axillary nerve
13. hives - intensely pruritic wheals that form after mast cell degranulation
Urticaria
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
AP depol opens voltage gated Ca channels - inducing NT release
Dysplastic nevus
14. In longitudinal bone growth - what model is made first (and By what cell) and What is it later replaced by (and By what cells) - process name
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Basal cell carcinoma - pearly papules - commonly with telangiectasias
15. fracture of a supracondylar humerus - nerve - motor - sensory - sign and more distal lesion causing the same nerve
Peroneal everts and dorsiflexes - foot dropPED; tibial inverts and plantarflexes - can't stand on Tip toes
Seborrheic keratosis
Median - lateral finger and wrist flexion - dorsal palmar aspects of lateral 3.5 fingers/thenar eminence - ape hand - carpal tunnel syndrome
Xeropthalmia - xerostomia - arthritis
16. epi of SLE
Female between 14 and 45 - mostly black
False positives on syphillis test (RPR/VRDL) due to antiphospholipid antibodies - cross react with cardiolipin
Pemphigus vulgaris
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
17. skin cancer associatd associated with excessive exposure to sunlight and arsenic
Integrin binds laminin in BM
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Squamous cell carcinoma
Making fist with a proximal median nerve lesion
18. What lesion causes dec in thumb fxn 'ape hand'
Erlenmeyer flask bones that flare out - narrowed foramina
Median nerve
In psoriasis - bleeding spots when scales are scraped off
Median nerve - same fingers but not on the hand
19. What are the layers of of the epidermis from surface to base
Corneum - lucidum - granulosum - spinosum - basalis
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Myosin light chain phosphotase
2/3 of the way from the umbilicus to the anterior superior iliac spine - appendix
20. papules and plaques with silvery scaling - especially on knees and elbows - acanthosis with parakeratotic scaling (nuclei sill in stratun corneum - nail pitting and arthritis
Psoriasis
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Calmodulin - complex activates myosin light chain kinase
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS
21. normal melanocyte number with dec melanin production due to inactivity of tyrosine
Precocious puberty
Loss of lateral lumbrical fxn - 2nd and 3d digits are clawed and can't extend
Albinism
Recurrent branch of the medain nerve
22. What TX prophylax against osteoporisi
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
Infraspinatus - laterally rotates arm
Dermatomyositis
Exercise and Ca ingestion before age 30
23. What is the primary screening test for lupus
ANA - sensitive but not specific
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
Actinic keratosis
GC and cGMP and inhibition of MLCK
24. Thenar eminence - nerve and muscles
Acanthosis
Dec estrogen causes inc bone resorption - postmenopausal
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
Integrin binds laminin in BM
25. white painless plaques on the tongue that cannot be scraped off - dz - population - implicated virus
Elevated ESR and nl CK - prednisone
Scleroderma
Hairy leukoplakia - HIV population - EBV mediated
Median nerve
26. locally invasive but rarely mets skin cancer - rolled edges - with central ulceration - cancer and gross path
Down T tubule
Lower trunk of brachial plexus
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Basal cell carcinoma - pearly papules - commonly with telangiectasias
27. What are characteristic findings of gout
Asymmetric - swollen - red - painful joint - often MTP (podagra) - tophus formation on external ear - olecranon bursa - achilles tendon
Cherry hemangioma
Rigor mortis
Endochondroma
28. What are the classic fractures in pts with osteoporosis
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29. Flat discloration <1cm seen in tinea versicolor
Plaque
Viral - maybe paramyxovirus
Verrucae vulgaris
Macule
30. What do lumbricals do
Wheal
Flex the MCP joints and extend both the DIP and PIP joints
GC and cGMP and inhibition of MLCK
Lower trunk of brachial plexus
31. Reduction of primarily trabecular (spongy) bone mass despite nl bone mineralization lab values
Crohns and ulcerative colitis
Actinic keratosis - risk proportional to epithelial dysplasia
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Osteoporosis
32. What is the classic presentation of osteoarthritis
Verrucae
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Macule
Pain in weight bearing joints at the end of the day and improving with rest
33. What are the bone mineral lab findings in paget's disease
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS
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
85% - advanced paternal age - or auto dominant inheritance
Serum ca - phos - PTH are nl alk phos elevated
34. What is the precursor to melanom
Bulla
Dysplastic nevus
Ligand binding leads to muscle depol
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
35. What nerve controls ab and adduction of the interossei muscles and What does it for the thumb and 4th and 5th lumbricals
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Vitiligo - dec number in melanocytes
Vesicle
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed
36. What nerve is injured by a fracture of the epicondyle of humerus or repeated minor traumas
Ulnar nerve
Keloid
Plaque
In psoriasis - bleeding spots when scales are scraped off
37. What causes total claw
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Making fist with a proximal median nerve lesion
AP depol opens voltage gated Ca channels - inducing NT release
38. What are the subQ rheumatoid nodules made of...
Urticaria
Fibrinoid necrosis surrounded by palisading histiocytes
Osteoarthritis
Inc spinosum - dec granulosum
39. Which muscle is the most common rotator cuff injury and What does it do
Basophilic - rhomboid crystals - weakly birefringent
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
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Supraspinatus - abducts the arm before the deltoid
40. What happens in the power stroke of skeletal muscle contraction
Down T tubule
Adductor policis brevis
Phosphate is liberated from the myosin head
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
41. What are the lab findings in osteitis fibrosa cystica
Urticaria
Squamous cell carcinoma
Vesicle
Inc Ca - dec phos - inc alk phos - inc PTH - brown tumors
42. Where does the muscle contraction travel after leaving the motor end plate
Down T tubule
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Psoriasis
43. pruritic - purple - polygonal papules - sawtooth infiltrate of lymphocytes at dermal - epidermal jxn - associated with hep C
Acanthosis
Lichen planus
Osteochondroma - exostosis
Precocious puberty
44. Where does squamous cell carcinoma of the skin typically appear - What is the histo - prognosis - and associations
Ulnar deviation - subluxation - bakers cysts (behind knee)
Actinic keratosis - risk proportional to epithelial dysplasia
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
45. dried exudates from a vesicle - bulla or pustule seen impetigo
Melasma (chloasma)
Impetigo - s aureus - s pyogenes
Serum ca - phos - alk phos are NL
Crust
46. What are the predisposing factors for osteoarthritis
Age - obesity and joint deformity
Dec Ca - dec phos - nl alk phos - inc PTH - soft bones
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Flex at the MCP
47. In which joints does pseudogout typically occur
85% - advanced paternal age - or auto dominant inheritance
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Muslce use - nerve stim/compound muscle test
Large goints (knee)
48. What are the lab findings in osteoporosis
Nl - decreased bone mass
Down T tubule
Phosphorylates myosin light chain which leads to cross bridge formation
Actin
49. What are the most common symtpoms of SLE
Fever - fatigue - weight loss - nonbacterial verruucous (Liebman - Sacks) endocarditis - hilar adenopathy - Raynauds
Dermatitis
Age - obesity and joint deformity
Endochondroma
50. Deposition of calcium pyrophosphate cyrstals within the joint space
Pseudogout
NC migration
Supraspinatus - abducts the arm before the deltoid
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed