Test your basic knowledge |

Musculoskeletal

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. What is the landmark for an LP
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
Iliac crest
Wheal
S100 - associated with sunligh exposure - fair skinned at risk - depth of tumor correlates with risk of mets - dark with irregular borders

2. In skeletal and smooth muscle contraction - when Ca2+ enters the cytoplasm - What does it do
Radial deviation of wrist upon flexion - ulnar claw hand - pope's blessing
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Osteochondroma - exostosis

3. Which type of muscle fiber is hypertrophied during weight training
Metaphysis of long bones - distal femur
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Type 2
Recurrent branch of the median nerve

4. Macule greater than 1cm
Patch
Wheal
Anti Scl70 - anti DNA topoisomerase I antibody
Basophilic - rhomboid crystals - weakly birefringent

5. Where is C7 dermatome
In psoriasis - bleeding spots when scales are scraped off
3rd finger
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -
Giant cell tumor (osteoclastoma) - double bubble or soap bubble

6. What nerve is compressed in carpal tunnel syndrome or a disclocation of this bone
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
After a large meal or EtOH conspumption
Median nerve - lunate bone
Dermatitis herpetiformis

7. What test if specific for lupus but doesn't indicate prognosis
The dermis
S100 - associated with sunligh exposure - fair skinned at risk - depth of tumor correlates with risk of mets - dark with irregular borders
Anti Smith
Long thoracic nerve

8. What nerve become injured in the incorrect use of a crutch
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Loss of medial lumbrical fxn; 4th and 5th digits are clawed - when try to open hand - pinky and ring finger stay clawed
Radial nerve becomes compressed in axilla
Pemphigus vulgaris

9. What kind of endocrine abnl are associated with McCune Albright
Axillary - deltoid - skin over deltoid - flattened deltoid
Precocious puberty
Osteoporosis
Large goints (knee)

10. epidermal hyperplasia (inc spinosum)
Acanthosis
Obturator - thigh adduction - medial thigh
Seborrheic keratosis
Vesicle

11. What are the motor - sensory deficits and sign of carpal tunnel syndrome
85% - advanced paternal age - or auto dominant inheritance
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Radial nerve becomes compressed in axilla

12. What is a positive Nikolsky's sign
Large goints (knee)
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Fracture of surgical neck - dislocation of the humerus - intramuscular injections
Paralysis of lateral rotators

13. What kind of bone tumor is associated with FAP and What is the finding
NC migration
Type III - RF
Melasma (chloasma)
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull

14. What is the classic triad of reactive arthritis
Pain in weight bearing joints at the end of the day and improving with rest
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Conjunctivitis and anterior uveitis - urethritis and arthritis

15. What is CREST syndrome and What antibody is it associated with
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
Dysplastic nevus
Medially rotates and adducts arm

16. inflammatory disorder affective synovial joints with pannus formation in joints
Rheumatoid arthritis
Wire - loop lesions in kidney with immune complex deposition - death from renal failure and infxns
Urticaria
ANA - sensitive but not specific

17. In smooth muscle contraction - What does Ca bind and What is the purpose
Axillary nerve
Anti - CCP - HLA- DR4
Ulnar
Calmodulin - complex activates myosin light chain kinase

18. What is the TX for acute gout
Nl - thickened dense bones
NSAIDs (indomethacin) colchicine
Trauma
Boutonniere - swan neck - zthumb

19. epi of SLE
Polymyositis - shoulders - perifasicular inflammation
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Lower trunk of brachial plexus
Female between 14 and 45 - mostly black

20. Depolarizaition causes what voltage sensitive receptor coupled to what other receptor to induce a conformational change In what structure - releasing what?
Ulnar nerve - intrinsic muscles of hand
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Gout
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+

21. What are the potential causes of gout

22. What is the characteristic appearance of bone - the common translocation - area of - and bones affected
HI shrinks - A stays same
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Torn MCL

23. On the palmar side of the hand - what dermatone covers the most of the thumb - 2nd - 3rd - and medial half of the 4th digits and What does it cover on the dorsal side
Median nerve - same fingers but not on the hand
Connects cells to underlying extracellular - bullous pemphigoid
McCune - Albright syndrome
Calmodulin - complex activates myosin light chain kinase

24. normal melanocyte number with dec melanin production due to inactivity of tyrosine
Actin
Albinism
Exercise and Ca ingestion before age 30
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory

25. What is a precursor to squamous cell carcinoma
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Actinic keratosis
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs

26. Where is T2 dermatome
Posterior hip dislocation - can't jump - climb stairs or rise from seated positions
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
Verrucae
Axilla

27. Where is T1 dermatome
Troponin C - conformational change that moves tropomyosin out the myosin binding groove on actin filaments
Gout
Medial forearm and arm to just under the axilla
Renal - pulm - CV - GI - 75% female

28. heliotrope rash 'shawl and face' rash - Gotton's papules - 'mechanic's hands'
Dermatomyositis
Radial nerve
Atopic dermatitis - eczema
MCP - PIP - no DIP

29. osteochondrosis has rare malignant transformation into what cancer
Acute back pain - loss of height - and kyphosis
Chondrosarcoma
NC migration
Inc blood flow from AV shunts can cause high output heart failure

30. deep tissue injury - crepitus from methane and CO2 production 'flesh eating bacteria' - condition and orgs
Anti Smith
Chondrosarcoma
Posterior cord
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes

31. interlacing trabeculae of woven bone surrounded by osteoblasts
Integrin binds laminin in BM
ANA - sensitive but not specific
Osteoid osteoma
Pain in weight bearing joints at the end of the day and improving with rest

32. What do pseudogout crystals appear like microscopically
Vesicle
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Basophilic - rhomboid crystals - weakly birefringent

33. immune mediated - widespread - non - caseating granulomas - dz - affected population and elevated serum level
Increase in both osteoblast and osteoclast activity
Exercise and Ca ingestion before age 30
Chondrosarcoma
Sarcoidosis - black females - ACE

34. What kind of jxn is the zona occludens andw What is is composed of...
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Erlenmeyer flask bones that flare out - narrowed foramina
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup

35. What are the signs of ulnar nerve injury

36. Seronegative spondyloarthropathis have what HLA association - and why are they seronegative - and who do they more often occur in
B27 - no RF - males
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis
AP depol opens voltage gated Ca channels - inducing NT release
Patch

37. Which muscle is the pitching injury and What does it do
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Infraspinatus - laterally rotates arm
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Ligand binding leads to muscle depol

38. Where do sebhorrheic keratosis lesions occur and in who
Staph scalded skin syndrome
Exercise and Ca ingestion before age 30
The dermis
Head - trunk - extremities - common benign neoplasm in older persons

39. What kind of hypersens rxn is RA - and what serum marker is present in 80% of RA pts
Type III - RF
Type 2
Paralysis of lateral rotators
Dorsal side of lateral hand - most of lateral surface of the thumb - no digits

40. pelvic fracture can cause injury to which nerve - and What are the motor and sens def
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Median nerve - same fingers but not on the hand
Femoral - thing flexion and leg extension - anterior thigh and medial leg

41. What do lumbricals do
Flex the MCP joints and extend both the DIP and PIP joints
Lung
Vertebral crush fractures - femoral neck fractures - distal radius (Colles') fracture
Morning stiffness for > 30 min improving with use - symmetry - systemic sx

42. What are defining lab findings for polymyalgia rheumatica and What is the TX
Obturator - thigh adduction - medial thigh
Medial forearm and arm to just under the axilla
Elevated ESR and nl CK - prednisone
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur

43. What do the branches of the deep ulnar nerve innervate
Verrucae
Keratoacanthoma
Interossei and adductor policis
Boutonniere - swan neck - zthumb

44. loss of what muscles in Erbs causes the medial rotation
Osteosarcoma - multiple myeloma
Paralysis of lateral rotators
Calmodulin - complex activates myosin light chain kinase
MCL - ACL - lateral meniscus (esp in athletes)

45. What is the clinically important landmark for pubendal nerve block and When is it used
Plaque
Erythema multiforme - can be macules - papules vesicles - target lesions -
Osteoporosis
Ischial spine - relieve pain during delivery

46. larger osteoid osteoma found in vertebral column
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases
Osteoblastoma
Myosin

47. Besides the skin - what other organ systems are commonly affected by scleroderma and who is primarily affected
Medial aspect
Nl - thickened dense bones
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Renal - pulm - CV - GI - 75% female

48. What nerve and branch are stretche by subluxation of the radius
Ephelis
Men - needle shaped and negatively birefringent = yellow crystals under parallel light
Deep branch of radial nerve
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)

49. What are the possible origins of the paget's disease
Viral - maybe paramyxovirus
Infraspinatus - laterally rotates arm
Acanthosis nigcricans
Paralysis of abductors

50. What are the associations for sjogrens syndrome
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Chondrosarcoma
Large goints (knee)