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. Where is C5 dermatome
Precocious puberty
Outer arm
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Medial forearm and arm to just under the axilla

2. blister containing pus
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Sarcoidosis - black females - ACE
Iliac crest
Pustule

3. What does the positive anterior drawer sign test indicate
Corneum - lucidum - granulosum - spinosum - basalis
Infraspinatus - laterally rotates arm
Tear of the ACL
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis

4. What is the Auspitz sign
Dec estrogen causes inc bone resorption - postmenopausal
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Cervical disk lesion
In psoriasis - bleeding spots when scales are scraped off

5. What lesion causes deltoid paralysis
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion
Integrin binds laminin in BM
Antibodies around cells of the epidermis in a reticular or netlike pattern
Axillary nerve

6. Contraction results in shortening of what bands - and what band remains the same length
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Vertebral crush fractures - femoral neck fractures - distal radius (Colles') fracture
HI shrinks - A stays same
MCP - PIP - no DIP

7. which muscle type is fast twitch and why are fibers white
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Tear of the ACL
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis

8. Where does squamous cell carcinoma of the skin typically appear - What is the histo - prognosis - and associations
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Psoriasis
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls

9. What are the the common causes of Erb palsy - and What are the associated findings
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Radial deviation of wrist upon flexion - ulnar claw hand - pope's blessing
Median nerve - same fingers but not on the hand
Polyostotic fibrous dysplasia

10. bening cartilaginous neoplasm found in intramedullary bone - usually distal extremities
Endochondroma
Cervical disk lesion
Medial forearm and arm to just under the axilla
Osteopetrosis - abnl fxn of osteoclasts

11. What protects the brachial plexus in clavicle fracture
Subclavius
Anterior interosseous nerve
Osteoarthritis
Cervical disk lesion

12. What are the layers of of the epidermis from surface to base
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Corneum - lucidum - granulosum - spinosum - basalis
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Antibodies around cells of the epidermis in a reticular or netlike pattern

13. osteochondrosis has rare malignant transformation into what cancer
Anti ds DNA - poor prognosis
Strawberry hemangioma
Fibrinoid necrosis surrounded by palisading histiocytes
Chondrosarcoma

14. What antibody is less sensitive than RF but more specific and What is the HLA association
Anti - CCP - HLA- DR4
Lower trunk of brachial plexus
Inc Ca - dec phos - inc alk phos - inc PTH - brown tumors
3rd finger

15. What is the most common NMJ disorder - What causes it and What are common symptoms
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Dorsal side of lateral hand - most of lateral surface of the thumb - no digits
Tear of the ACL
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -

16. What causes osteomalacia/ricketts - why - and What therapy can reverse the symptoms
Dermatitis
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Exercise and Ca ingestion before age 30
Actin

17. What does I'M DAMN SHARP stand for
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Fever - fatigue - weight loss - nonbacterial verruucous (Liebman - Sacks) endocarditis - hilar adenopathy - Raynauds
Paralysis of abductors

18. large fluid containing blisters seen in bullous pemphigoid
Interossei and adductor policis
Bulla
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody

19. What kind of jxn is the zona occludens andw What is is composed of...
Calmodulin - complex activates myosin light chain kinase
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins

20. warts on hands
Verrucae vulgaris
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
Dec estrogen causes inc bone resorption - postmenopausal
Pustule

21. most common benign tumor - mature bone with cartilaginous cap - men <25 - origintate froms long metaphysis
Ischial spine - relieve pain during delivery
Osteochondroma - exostosis
Ulnar nerve
Psoriasis

22. How does the radial nerve in the spiral groove become injured
Medial forearm and arm to just under the axilla
Squamous cell carcinoma
Lesioned by midshaft fracture of humerus
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed

23. What are the lab findings in osteopetrosis
Inc blood flow from AV shunts can cause high output heart failure
Deep branch of radial nerve
Steroids
Nl - thickened dense bones

24. In skeletal and smooth muscle contraction - when Ca2+ enters the cytoplasm - What does it do
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Muslce use - nerve stim/compound muscle test

25. immune mediated - widespread - non - caseating granulomas - dz - affected population and elevated serum level
GC and cGMP and inhibition of MLCK
Verrucae
Sarcoidosis - black females - ACE
Post GI infxn or chlamydia

26. Trauma to lateral aspect of leg or fibula neck fracture - nerve - motor and sens def
Outer arm
Post GI infxn or chlamydia
Serum ca - phos - alk phos are NL
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory

27. What are the histo findings in an osteoclastoma
Sites of tibial attachment
Viral - maybe paramyxovirus
Acute back pain - loss of height - and kyphosis
Spindle shaped cells with multinucleated giant cells

28. Which muscle is the most common rotator cuff injury and What does it do
Supraspinatus - abducts the arm before the deltoid
Medially rotates and adducts arm
Pseudogout
NC migration

29. Where does the muscle contraction travel after leaving the motor end plate
Ligand binding leads to muscle depol
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Ulnar deviation - subluxation - bakers cysts (behind knee)
Down T tubule

30. What molecule maintatins integrity of basement membrane and What does it bind
Integrin binds laminin in BM
Phosphorylates myosin light chain which leads to cross bridge formation
Radial nerve
Post GI infxn or chlamydia

31. What lesion causes winged scapula
Obturator - thigh adduction - medial thigh
Atopic dermatitis - eczema
Expansile glistening mass within the medullary cavity
Long thoracic nerve

32. freckle - normal number of melanocytes - inc melanin pigment
Parotid enlargement - inc risk of B cell lymphoma - dental caries
Patch
Fibrinoid necrosis surrounded by palisading histiocytes
Ephelis

33. What is contained within epithelial granulomas of pts with sarcoid
Boutonniere - swan neck - zthumb
Interossei and adductor policis
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies

34. Pain and stiffness in shoulders and hips - fever malaise and weight loss - no weakness - pts over 50 - associated with HA and jaw pain
Boutonniere - swan neck - zthumb
Anti Scl70 - anti DNA topoisomerase I antibody
Radial nerve becomes compressed in axilla
Polymyaglia rheumatica associated with temporal (giant cell) arteritis

35. acute painful spreading infxn of dermis and subQ tissues - condition and orgs
Median nerve
Type 2
Cellulitis - s aureus - s pyogenes
Acanthosis nigcricans

36. What injury causes injury to the MC nerve and what motor and sensory defs dose it cause
Sites of tibial attachment
Polyostotic fibrous dysplasia
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm

37. inflammatory disorder affective synovial joints with pannus formation in joints
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Pagets dz - bone infarcts - radiation - familial retinoblastoma - codman's triangle or sunburst pattern from elevation of periosteum - poor prognsosis
Rheumatoid arthritis
Axillary nerve

38. What are the predisposing factors for osteoarthritis
Age - obesity and joint deformity
Widespread skin involvment - rapid progression - early visceral involvement
Gout
Osteoid osteoma

39. What is the clinically important landmark for pubendal nerve block and When is it used
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Serum ca - phos - alk phos are NL
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Ischial spine - relieve pain during delivery

40. What is a very specific test for lupus
Acantholysis
Adduct the fingers
Anti ds DNA - poor prognosis
Head - trunk - extremities - common benign neoplasm in older persons

41. What nerve and branch are stretche by subluxation of the radius
Age - obesity and joint deformity
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
Deep branch of radial nerve
Recurrent branch of the medain nerve

42. What kind of endocrine abnl are associated with McCune Albright
Chondrosarcoma - pelvis - spine - scapula - humerus - tibia - or femur
Long thoracic nerve
Precocious puberty
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop

43. What organisms can cause chronic infectious arthritis
TB from dissemination and lyme dz
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Acanthosis
Staph scalded skin syndrome

44. What does soft bones result from and What is the dz called in adults and children
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
Gout
Ulnar nerve - fracture of hook of hamate
Impetigo - s aureus - s pyogenes

45. What are defining lab findings for polymyalgia rheumatica and What is the TX
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Thymoma
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
Elevated ESR and nl CK - prednisone

46. What do lupus pts falsely test positive for syphillis
False positives on syphillis test (RPR/VRDL) due to antiphospholipid antibodies - cross react with cardiolipin
Widespread skin involvment - rapid progression - early visceral involvement
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases
4th and 5th finger

47. anaplastic small blue cell malignant tumor - most common in boys < 15 - dz and prognosis
Fever - fatigue - weight loss - nonbacterial verruucous (Liebman - Sacks) endocarditis - hilar adenopathy - Raynauds
Ewings sarcoma - aggressive with early mets - but responsive to chemo
Phosphorylates myosin light chain which leads to cross bridge formation
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity

48. What kind of hypersens rxn is RA - and what serum marker is present in 80% of RA pts
Type III - RF
Rheumatoid arthritis
Squamous cell carcinoma
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar

49. What causes heart failure in with Paget's disease
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages
Squamous cell carcinoma
Inc blood flow from AV shunts can cause high output heart failure
In pemphis vulgaris - separation of epidermis upon manual stroking of skin

50. What nerve is injured by a fracture of the epicondyle of humerus or repeated minor traumas
Rheumatoid arthritis
Ulnar nerve
Ulnar deviation - subluxation - bakers cysts (behind knee)
After a large meal or EtOH conspumption