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Test your basic knowledge |
Musculoskeletal
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Subject
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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. subchondreal cysts - sclerosis - osteophytes - joint space narrowing - eburnation - hebereden's nodes (DIP) bouchard nodes (PIP) - characteristic findings of this dz
Seborrheic keratosis
Osteoarthritis
Integrin binds laminin in BM
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
2. What other muscle in the thenar eminence adducts the thumb
Teres minor
Compressed by cervical rib or pancoasts tumor - leads to klumpke's
Adductor policis brevis
Fibrinoid necrosis surrounded by palisading histiocytes
3. Dermatomyositis places the pt at inc risk For what malignancy in particular
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
Lung
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
4. dactylitis and pencil in cup deformity on xray - patchy skin rash and joint pain
Nl - decreased bone mass
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Vertebral crush fractures - femoral neck fractures - distal radius (Colles') fracture
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
5. Pain and stiffness in shoulders and hips - fever malaise and weight loss - no weakness - pts over 50 - associated with HA and jaw pain
Sites of tibial attachment
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Anti - CCP - HLA- DR4
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes
6. What injury causes injury to the MC nerve and what motor and sensory defs dose it cause
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Median nerve
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity
Viral - maybe paramyxovirus
7. What does ATP do in skeletal muscle contraction
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Pemphigus vulgaris
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
NC migration
8. What kind of hypersens rxn is RA - and what serum marker is present in 80% of RA pts
Dry eyes - dry mouth - nasal and vaginal dryness - chronic bronchitis - reflux esophagitis and No arthritis
Exercise and Ca ingestion before age 30
Type III - RF
MCL - ACL - lateral meniscus (esp in athletes)
9. What are the lab findings in osteitis fibrosa cystica
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Torn MCL
Inc Ca - dec phos - inc alk phos - inc PTH - brown tumors
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
10. Where do sebhorrheic keratosis lesions occur and in who
Nevocellular nevus
Head - trunk - extremities - common benign neoplasm in older persons
Down T tubule
Osteosarcoma - multiple myeloma
11. What form of polyostotic fibrous dysplasia has multiple unilateral bones lesions associated with endocrine abnl and unilateral pigmented skin lesions - caf
Obturator - thigh adduction - medial thigh
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
McCune - Albright syndrome
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
12. What causes osteomalacia/ricketts - why - and What therapy can reverse the symptoms
Inc spinosum - dec granulosum
Mesenchymal stem cells in periosteum
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Widespread skin involvment - rapid progression - early visceral involvement
13. In skeletal and smooth muscle contraction - when Ca2+ enters the cytoplasm - What does it do
Femoral - thing flexion and leg extension - anterior thigh and medial leg
Peroneal everts and dorsiflexes - foot dropPED; tibial inverts and plantarflexes - can't stand on Tip toes
Ulnar deviation - subluxation - bakers cysts (behind knee)
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
14. What is the characteristic appearance of bone - the common translocation - area of - and bones affected
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Condyloma acuminatum - caused by HPV
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
15. What are the lab findings in osteoporosis
Paralysis of abductors
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
Pseudogout
Nl - decreased bone mass
16. white painless plaques on the tongue that cannot be scraped off - dz - population - implicated virus
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Axillary - deltoid - skin over deltoid - flattened deltoid
Hairy leukoplakia - HIV population - EBV mediated
Iliac crest
17. What do xray show in osteopetrosis and What do potential CN abnl result from
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Ewings sarcoma - aggressive with early mets - but responsive to chemo
Erlenmeyer flask bones that flare out - narrowed foramina
18. What is the Auspitz sign
In psoriasis - bleeding spots when scales are scraped off
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit
Tear of the ACL
Flex at the MCP
19. pruritic - purple - polygonal papules - sawtooth infiltrate of lymphocytes at dermal - epidermal jxn - associated with hep C
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
Squamous cell carcinoma
Myosin
Lichen planus
20. In smooth muscle contraction - What does Ca bind and What is the purpose
Calmodulin - complex activates myosin light chain kinase
The dermis
Restrictive lung disease - bilateral hilar lymphadenopathy - erythema nodosum - Bell's palsy
Plaque
21. 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
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Outer arm
Inc CK - inc aldolase - and positive ANA and anti Jo -1 - steroids
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
22. What signal initiates a muscle contraction
Integrin binds laminin in BM
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Medial 1.5 fingers - hypothenar eminence
AP depol opens voltage gated Ca channels - inducing NT release
23. Other than characteristic joints and subQ nodules - What are the other findings classicly in RA
4th and 5th finger
Medial aspect
Ulnar deviation - subluxation - bakers cysts (behind knee)
Femoral - thing flexion and leg extension - anterior thigh and medial leg
24. herald path followed by days later christmas tree distribution - multiple papular eruptions; remits spontaneously
Ulnar nerve - intrinsic muscles of hand
Pityriasis rosea
Acantholysis
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid
25. In which gender is gout more common and What does the crystals appear like microscopically
Men - needle shaped and negatively birefringent = yellow crystals under parallel light
Elevated ESR and nl CK - prednisone
Medial 1.5 fingers - hypothenar eminence
Serum ca - phos - alk phos are NL
26. What is the clinically important landmark for pubendal nerve block and When is it used
Ischial spine - relieve pain during delivery
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -
Type 2
Anti - CCP - HLA- DR4
27. What test if specific for lupus but doesn't indicate prognosis
Anti Smith
Wheal
Atopic dermatitis - eczema
Osteosarcoma - multiple myeloma
28. What nerve become injured in the incorrect use of a crutch
Verrucae vulgaris
Type III - RF
Radial nerve becomes compressed in axilla
Interossei and adductor policis
29. Loss of what muslces in Erbs causes the limb to hang by side
Ulnar nerve - fracture of hook of hamate
Type 2
Paralysis of abductors
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
30. Where does squamous cell carcinoma of the skin typically appear - What is the histo - prognosis - and associations
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
Ewings sarcoma - aggressive with early mets - but responsive to chemo
Verrucae vulgaris
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
31. What medication is contraindicated in osteoporosis
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Lichen planus
Ephelis
Glucocorticoids
32. Very superfiicial skin infection - honey colored crusting - very contagious - condition and organisms
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
Impetigo - s aureus - s pyogenes
Axilla
Ulnar nerve
33. What are the lab findings in pagets disease
Dry eyes - dry mouth - nasal and vaginal dryness - chronic bronchitis - reflux esophagitis and No arthritis
Serum ca - phos - alk phos are NL
Inc alk phos - abnl bone architecture
Anti Scl70 - anti DNA topoisomerase I antibody
34. interlacing trabeculae of woven bone surrounded by osteoblasts
Boutonniere - swan neck - zthumb
Iliac crest
Polymyositis - shoulders - perifasicular inflammation
Osteoid osteoma
35. Other than N. gono - what organisms can cause infectious - septic arthritis
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Paralysis of abductors
Muslce use - nerve stim/compound muscle test
S. aureus - streptococcus
36. 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
ANA - sensitive but not specific
Medial aspect
Melasma (chloasma)
37. What are the motor - sensory deficits and sign of carpal tunnel syndrome
Dermatomyositis
Muslce use - nerve stim/compound muscle test
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion
Osteochondroma - exostosis
38. Through what pathway does NO work and What is the downstream effect
Steroids
Parakeratosis
Compressed by cervical rib or pancoasts tumor - leads to klumpke's
GC and cGMP and inhibition of MLCK
39. Achondroplasia is a failure of what process which results in which characteristic findings
Nl - thickened dense bones
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Median nerve - same fingers but not on the hand
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
40. blister containing pus
NC migration
S. aureus - streptococcus
Pustule
Upper trunk of brachial plexus
41. What are the predisposing factors for osteoarthritis
Gout
Serum ca - phos - alk phos are NL
Age - obesity and joint deformity
Conjunctivitis and anterior uveitis - urethritis and arthritis
42. What are the signs of ulnar nerve injury
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43. What enzyme is necessary for smooth muscle relaxation after contraction
Myosin light chain phosphotase
Pseudogout
Lesioned by midshaft fracture of humerus
NSAIDs (indomethacin) colchicine
44. large fluid containing blisters seen in bullous pemphigoid
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity
Bulla
Median nerve
Anti Smith
45. excessive fibrosis and collagen deposition throughout the body - common in skin manifesting as puffy taut skin with absence of wrinkles
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Scleroderma
Calmodulin - complex activates myosin light chain kinase
Vertebral crush fractures - femoral neck fractures - distal radius (Colles') fracture
46. what changes are seen in stratum spinosum and granulosum in psoriasis
Inc spinosum - dec granulosum
Scleroderma
Phosphate is liberated from the myosin head
MCP - PIP - no DIP
47. larger osteoid osteoma found in vertebral column
Radial deviation of wrist upon flexion - ulnar claw hand - pope's blessing
Osteoblastoma
2/3 of the way from the umbilicus to the anterior superior iliac spine - appendix
Fibrinoid necrosis surrounded by palisading histiocytes
48. hypothenar eminence - nerve and muscles
Melasma (chloasma)
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Osteogenic carcinoma
Lichen planus
49. dried exudates from a vesicle - bulla or pustule seen impetigo
Crust
Peroneal everts and dorsiflexes - foot dropPED; tibial inverts and plantarflexes - can't stand on Tip toes
Elevated ESR and nl CK - prednisone
Adductor policis brevis
50. chronic inflammatory disease of sacroiliac joints and spine - dz - associations
Precocious puberty
Pemphigus vulgaris
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Crohns and ulcerative colitis
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