Test your basic knowledge |

Musculoskeletal

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. hyperkeratosis with retention of nuclei in stratum corneum seen in psoriasis
Bulla
Impetigo - s aureus - s pyogenes
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Parakeratosis

2. premalignant lesions caused by sun exposure - small rough - erythematous or brownish papules - cutaenous horns - Name and risk of carcinoma
Osteoarthritis
Keloid
Actinic keratosis - risk proportional to epithelial dysplasia
Tear of the ACL

3. What are the systemic symptoms found in RA
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Fever - fatigue - pleuritis - pericarditis
Vesicle
Adductor policis brevis

4. What lesion causes deltoid paralysis
Axillary nerve
Obturator - thigh adduction - medial thigh
Anti - histone
Abduct the fingers

5. What other muscle in the thenar eminence adducts the thumb
NSAIDs (indomethacin) colchicine
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
Adductor policis brevis
Boutonniere - swan neck - zthumb

6. Where does squamous cell carcinoma of the skin typically appear - What is the histo - prognosis - and associations
Rheumatoid arthritis
3rd finger
Pustule
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls

7. What is the clinically important landmark for pubendal nerve block and When is it used
Down T tubule
Ischial spine - relieve pain during delivery
Keloid
Antibodies around cells of the epidermis in a reticular or netlike pattern

8. What is the landmark for an LP
Dry eyes - dry mouth - nasal and vaginal dryness - chronic bronchitis - reflux esophagitis and No arthritis
Iliac crest
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
Osteoblastoma

9. Which muscle fiber type is slow twitch and why are fibers red
Type 1 - inc mitochondria and myoglobin conc - inc OXPHOS leading to sustained conctraction
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Lower trunk of brachial plexus
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated

10. What are the signs of ulnar nerve injury

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

11. What causes osteoporosis type 1 and When does it typically occur
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Dec estrogen causes inc bone resorption - postmenopausal

12. What form of polyostotic fibrous dysplasia has multiple unilateral bones lesions associated with endocrine abnl and unilateral pigmented skin lesions - caf
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Fever - fatigue - pleuritis - pericarditis
McCune - Albright syndrome
Anti ds DNA - poor prognosis

13. What is contained within epithelial granulomas of pts with sarcoid
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies
NSAIDs (indomethacin) colchicine
Osteochondroma - exostosis

14. What are the lab findings in osteopetrosis
Ulnar nerve - intrinsic muscles of hand
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid
Nl - thickened dense bones
Palisading

15. large fluid containing blisters seen in bullous pemphigoid
Bulla
Trauma
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -

16. Where are most osteoid osteoma found and In what population
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
3rd finger
< 2mc found in proximal tibia and femur - men < 25
Over deltoid

17. 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
Men and women > 70 - senile osteporosis
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Femoral - thing flexion and leg extension - anterior thigh and medial leg
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling

18. What causes hypercalcemia in pts with sarcoid
In psoriasis - bleeding spots when scales are scraped off
Renal - pulm - CV - GI - 75% female
Osteoarthritis
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages

19. How is diffuse scleroderma characterized
Elevated ESR and nl CK - prednisone
Dermatitis herpetiformis
Widespread skin involvment - rapid progression - early visceral involvement
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS

20. chronic inflammatory disease of sacroiliac joints and spine - dz - associations
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Increase in both osteoblast and osteoclast activity
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Osteoarthritis

21. What kind of jxn is in the zona adherens and Where is it - What is it composed of - and what ion does it does it depend on...
Muslce use - nerve stim/compound muscle test
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Ulnar nerve

22. Patients with pagets disease can develop what cancer
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Osteogenic carcinoma
Lesioned by midshaft fracture of humerus
AP depol opens voltage gated Ca channels - inducing NT release

23. What antibodies is diffuse scleroderma associated with
Degenerative injury due to repeated use - tiny tears in the tendons and muscles - may be inflammatory - lateral epicondyle is tennis - medial epicondyle is golf
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Anti Scl70 - anti DNA topoisomerase I antibody

24. In a fracture of the midshaft of the humerus - or extended compression of axilla - nerve - motor - sensory - sign
Parakeratosis
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop
Mosiac bone pattern - long bone chalk stick fractures - increased hat size or hearing loss due to auditory foramen narrowing
Post GI infxn or chlamydia

25. heliotrope rash 'shawl and face' rash - Gotton's papules - 'mechanic's hands'
Dec estrogen causes inc bone resorption - postmenopausal
Medially rotates and adducts arm
Dermatomyositis
Acantholysis

26. Other than N. gono - what organisms can cause infectious - septic arthritis
Radial nerve becomes compressed in axilla
S. aureus - streptococcus
Pityriasis rosea
Muslce use - nerve stim/compound muscle test

27. Achondroplasia is a failure of what process which results in which characteristic findings
Torn MCL
ANA - sensitive but not specific
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Erythema nodosum

28. What other lesion can cause the appearnce of the ulnar claw
Making fist with a proximal median nerve lesion
Actinic keratosis
Antibodies around cells of the epidermis in a reticular or netlike pattern
Condyloma acuminatum - caused by HPV

29. What is the power stroke of muscle contraction
Myosin releases bound ADP and is displaced on the actin filament
Crohns and ulcerative colitis
Verrucae vulgaris
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion

30. What happens in the power stroke of skeletal muscle contraction
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
Phosphate is liberated from the myosin head
Actinic keratosis
Medial aspect

31. malignant cartilaginous tumor in men 30 to 60 - Name and common location
Chondrosarcoma - pelvis - spine - scapula - humerus - tibia - or femur
3rd finger
Polymyositis - shoulders - perifasicular inflammation
Femoral - thing flexion and leg extension - anterior thigh and medial leg

32. osteochondrosis has rare malignant transformation into what cancer
Chondrosarcoma
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop
Widespread skin involvment - rapid progression - early visceral involvement
Myosin releases bound ADP and is displaced on the actin filament

33. Where is osteosarcoma found in the bone
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Metaphysis of long bones - distal femur
Anterior interosseous nerve

34. How is chondrosarcoma described
Lower trunk of brachial plexus
Pityriasis rosea
Expansile glistening mass within the medullary cavity
Radial deviation of wrist upon flexion - ulnar claw hand - pope's blessing

35. What are the bone mineralization lab findings in osteopetrosis
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Osteoblastoma
Boutonniere - swan neck - zthumb
Serum ca - phos - alk phos are NL

36. What is the Auspitz sign
Outer arm
Ulnar deviation - subluxation - bakers cysts (behind knee)
In psoriasis - bleeding spots when scales are scraped off
Median nerve - lunate bone

37. Who does osteoporosis type 2 effect
Men and women > 70 - senile osteporosis
Widespread skin involvment - rapid progression - early visceral involvement
Pseudogout
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction

38. What are the causes of inferior trunk plexus compression and What are the findings
Upper trunk of brachial plexus
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
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
False positives on syphillis test (RPR/VRDL) due to antiphospholipid antibodies - cross react with cardiolipin

39. What nerve is injured in a fracutre of the hook of hamate
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Ulnar nerve
Mosiac bone pattern - long bone chalk stick fractures - increased hat size or hearing loss due to auditory foramen narrowing
Serum ca - phos - alk phos are NL

40. hyperplasia of stratum spinosum - associated with hyperinsulinemia (cushings - DM) and visceral malignancy
Upper trunk of brachial plexus
Female between 14 and 45 - mostly black
Acanthosis nigcricans
Polymyaglia rheumatica associated with temporal (giant cell) arteritis

41. small fluid containing blister seen in chickenpox
Vesicle
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Allopurinaol - uricosurics (probenicid)
Lung

42. What are the the common causes of Erb palsy - and What are the associated findings
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Fever - fatigue - pleuritis - pericarditis
Serum ca - phos - PTH are nl alk phos elevated

43. epi of SLE
Ribonucleoprotein antigents - SS- A and SS- B (Ro and La)
Anti - histone
Recurrent branch of the median nerve
Female between 14 and 45 - mostly black

44. precipitation of monosodium urate crystals into joints due to hyperuricemia
Fracture of surgical neck - dislocation of the humerus - intramuscular injections
Conjunctivitis and anterior uveitis - urethritis and arthritis
TB from dissemination and lyme dz
Gout

45. What causes total claw
Inc blood flow from AV shunts can cause high output heart failure
Ulnar nerve - intrinsic muscles of hand
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Wire - loop lesions in kidney with immune complex deposition - death from renal failure and infxns

46. warts on hands
Verrucae vulgaris
Dermatitis herpetiformis
Fibrinoid necrosis surrounded by palisading histiocytes
Phosphorylated

47. How does the radial nerve in the spiral groove become injured
Lesioned by midshaft fracture of humerus
Osteogenic carcinoma
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Tear of the ACL

48. What does lack of ATP cause
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
MCP - PIP - no DIP
Rigor mortis
Pemphigus vulgaris

49. What is the TX for chronic gout
Allopurinaol - uricosurics (probenicid)
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
Interossei and adductor policis

50. Anterior hip dislocation causes injury to what nerve and What are the motor and sensory defs
Nl - thickened dense bones
Obturator - thigh adduction - medial thigh
Patch
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit