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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. Which muscle laterally rotates and adducts arm
Axilla
Down T tubule
Teres minor
Tear of the ACL
2. Where do sebhorrheic keratosis lesions occur and in who
Pustule
Osteoblastoma
Verrucae
Head - trunk - extremities - common benign neoplasm in older persons
3. small fluid containing blister seen in chickenpox
Recurrent branch of the medain nerve
Boutonniere - swan neck - zthumb
Vesicle
Dermatomyositis
4. 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
Thymoma
Fever - fatigue - pleuritis - pericarditis
Acanthosis
5. What are the predisposing factors for osteoarthritis
Phosphate is liberated from the myosin head
Age - obesity and joint deformity
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
TB from dissemination and lyme dz
6. In which joints does pseudogout typically occur
Strawberry hemangioma
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases
Large goints (knee)
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed
7. Who does osteoporosis type 2 effect
Long thoracic nerve
Men and women > 70 - senile osteporosis
Ischial spine - relieve pain during delivery
Median nerve - same fingers but not on the hand
8. What is the classic presentation of RA
In psoriasis - bleeding spots when scales are scraped off
Spindle shaped cells with multinucleated giant cells
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
Polyostotic fibrous dysplasia
9. Contraction results in shortening of what bands - and what band remains the same length
Muslce use - nerve stim/compound muscle test
Fibrinoid necrosis surrounded by palisading histiocytes
HI shrinks - A stays same
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
10. What is the precursor to melanom
Obturator - thigh adduction - medial thigh
Tibial - foot inversioon and plantarflexion; toe flexion - sole of foot is sensory
Dysplastic nevus
Endochondroma
11. MG is associated with what neoplasm
McCune - Albright syndrome
3rd finger
Thymoma
Inc alk phos - abnl bone architecture
12. Why does EtOH consumption precipitate gout
Rheumatoid arthritis
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
Pagets dz - bone infarcts - radiation - familial retinoblastoma - codman's triangle or sunburst pattern from elevation of periosteum - poor prognsosis
Dorsal side of lateral hand - most of lateral surface of the thumb - no digits
13. What antibodies is diffuse scleroderma associated with
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Anti Scl70 - anti DNA topoisomerase I antibody
Verrucae vulgaris
Long thoracic nerve
14. In a fractured surgical neck of humerus or dislocation of humeral head - What is the nerve injury - motor deficit - sensory deficit
Axillary - deltoid - skin over deltoid - flattened deltoid
Over deltoid
Posterior hip dislocation - can't jump - climb stairs or rise from seated positions
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
15. What do pseudogout crystals appear like microscopically
Crust
Basophilic - rhomboid crystals - weakly birefringent
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
16. What do palmar interosseous muscles do
Adduct the fingers
Polymyositis - shoulders - perifasicular inflammation
Down T tubule
Anti ds DNA - poor prognosis
17. What injury causes injury to the MC nerve and what motor and sensory defs dose it cause
Nevocellular nevus
Long thoracic nerve
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Calmodulin - complex activates myosin light chain kinase
18. What nerve is injured by a fracture of the epicondyle of humerus or repeated minor traumas
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit
Ulnar nerve
Radial deviation of wrist upon flexion - ulnar claw hand - pope's blessing
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
19. dried exudates from a vesicle - bulla or pustule seen impetigo
Pemphigus vulgaris
Infraspinatus - laterally rotates arm
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion
Crust
20. malignant cartilaginous tumor in men 30 to 60 - Name and common location
Chondrosarcoma - pelvis - spine - scapula - humerus - tibia - or femur
Median - lateral finger and wrist flexion - dorsal palmar aspects of lateral 3.5 fingers/thenar eminence - ape hand - carpal tunnel syndrome
S. aureus - streptococcus
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
21. How is the lower trunk of the brachia plexus injured and what results from it
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22. What lesion causes wrist drop
Lesioned by midshaft fracture of humerus
Deep branch of radial nerve
Posterior cord
Ulnar nerve - fracture of hook of hamate
23. 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
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Phosphate is liberated from the myosin head
Sites of tibial attachment
24. hyperkeratosis with retention of nuclei in stratum corneum seen in psoriasis
Parakeratosis
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Endochondroma
Connects cells to underlying extracellular - bullous pemphigoid
25. What do the branches of the deep ulnar nerve innervate
Type III - RF
Interossei and adductor policis
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Ligand binding leads to muscle depol
26. What other lesion can cause the appearnce of the ulnar claw
Making fist with a proximal median nerve lesion
Lesioned by midshaft fracture of humerus
NSAIDs (indomethacin) colchicine
Mosiac bone pattern - long bone chalk stick fractures - increased hat size or hearing loss due to auditory foramen narrowing
27. papules and plaques with silvery scaling - especially on knees and elbows - acanthosis with parakeratotic scaling (nuclei sill in stratun corneum - nail pitting and arthritis
Hairy leukoplakia - HIV population - EBV mediated
Papule
Inc CK - inc aldolase - and positive ANA and anti Jo -1 - steroids
Psoriasis
28. loss of what muscles in Erbs causes the medial rotation
Recurrent branch of the medain nerve
Paralysis of lateral rotators
Verrucae vulgaris
Actin
29. What are the lab findings in osteoporosis
Psoriasis
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
Nl - decreased bone mass
30. What does abnl passive abduction of the knee indicate
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Erythema nodosum
Torn MCL
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed
31. What does subscapularis do
Gout
Troponin C - conformational change that moves tropomyosin out the myosin binding groove on actin filaments
Medially rotates and adducts arm
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
32. What are the systemic symptoms found in RA
Loss of medial lumbrical fxn; 4th and 5th digits are clawed - when try to open hand - pinky and ring finger stay clawed
Cellulitis - s aureus - s pyogenes
Melasma (chloasma)
Fever - fatigue - pleuritis - pericarditis
33. What causes the symptoms of MG to worsen - and What is used to diagnose
Cellulitis - s aureus - s pyogenes
Condyloma acuminatum - caused by HPV
Integrin binds laminin in BM
Muslce use - nerve stim/compound muscle test
34. Where is C4 dermatome
Over deltoid
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Actin
Viral - maybe paramyxovirus
35. irregular raised lesion resulting from scar tissue hypertrophy - follows trauma to skin - common to african americans see in T. pertenue (yaws)
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Keloid
The dermis
Vitiligo - dec number in melanocytes
36. What is below the epidermis
Mesenchymal stem cells in periosteum
Median nerve - lunate bone
The dermis
Loss of medial lumbrical fxn; 4th and 5th digits are clawed - when try to open hand - pinky and ring finger stay clawed
37. What kind of endocrine abnl are associated with McCune Albright
Precocious puberty
Parakeratosis
Lung
Infraspinatus - laterally rotates arm
38. chronic inflammatory disease of sacroiliac joints and spine - dz - associations
Pain in weight bearing joints at the end of the day and improving with rest
Polyostotic fibrous dysplasia
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
39. freckle - normal number of melanocytes - inc melanin pigment
Atopic dermatitis - eczema
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Ephelis
Post GI infxn or chlamydia
40. hypothenar eminence - nerve and muscles
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Myosin releases bound ADP and is displaced on the actin filament
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
Obturator - thigh adduction - medial thigh
41. What does I'M DAMN SHARP stand for
Ephelis
Verrucae
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity
42. Which nerve is compressed in deep forearm
Strawberry hemangioma
Anterior interosseous nerve
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Obturator - thigh adduction - medial thigh
43. What are the possible origins of the paget's disease
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Viral - maybe paramyxovirus
Seborrheic keratosis
Cervical disk lesion
44. What nerve is injured in a posterior hip dislocation or polio and What are the motor defs
Dermatomyositis
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
Vertebral crush fractures - femoral neck fractures - distal radius (Colles') fracture
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
45. What enzyme defect in responsible for osteopetrosis
Carbonic anhydrase II
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Large goints (knee)
Medial 1.5 fingers - hypothenar eminence
46. 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
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Psoriasis
Teres minor
47. What is the clinically important landmark for pubendal nerve block and When is it used
Ischial spine - relieve pain during delivery
Anti - CCP - HLA- DR4
Cervical disk lesion
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
48. Where is C7 dermatome
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -
Chondrosarcoma
Recurrent branch of the median nerve
3rd finger
49. In skeletal and smooth muscle contraction - when Ca2+ enters the cytoplasm - What does it do
Plaque
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
Cervical disk lesion
50. pelvic fracture can cause injury to which nerve - and What are the motor and sens def
Dermatitis herpetiformis
Medial forearm and arm to just under the axilla
Renal - pulm - CV - GI - 75% female
Femoral - thing flexion and leg extension - anterior thigh and medial leg
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