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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. What are the bone mineralization lab findings in osteopetrosis
Acute back pain - loss of height - and kyphosis
Serum ca - phos - alk phos are NL
Anti Smith
Dysplastic nevus
2. Which muscle is the most common rotator cuff injury and What does it do
Myosin light chain phosphotase
Myosin releases bound ADP and is displaced on the actin filament
Median nerve
Supraspinatus - abducts the arm before the deltoid
3. heliotrope rash 'shawl and face' rash - Gotton's papules - 'mechanic's hands'
Infraspinatus - laterally rotates arm
Post GI infxn or chlamydia
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Dermatomyositis
4. What muscles of the shoulder form the rotator cuff
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Troponin C - conformational change that moves tropomyosin out the myosin binding groove on actin filaments
Phosphate is liberated from the myosin head
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS
5. What is the landmark for an LP
Myosin
Spindle shaped cells with multinucleated giant cells
Fever - fatigue - weight loss - nonbacterial verruucous (Liebman - Sacks) endocarditis - hilar adenopathy - Raynauds
Iliac crest
6. Loss of what muslces in Erbs causes the limb to hang by side
Osteoarthritis
Paralysis of abductors
Impetigo - s aureus - s pyogenes
Pityriasis rosea
7. What antibody is less sensitive than RF but more specific and What is the HLA association
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Anti - CCP - HLA- DR4
Dermatitis
Increase in both osteoblast and osteoclast activity
8. Loss of what muscles in Erbs causes the forearm to be pronated
Median nerve
Endochondroma
Biceps
ANA - sensitive but not specific
9. What does IM reveal in pemphigus vulgaris
Antibodies around cells of the epidermis in a reticular or netlike pattern
Actinic keratosis
Men - needle shaped and negatively birefringent = yellow crystals under parallel light
Osteochondroma - exostosis
10. What do palmar interosseous muscles do
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
Adduct the fingers
Erythema nodosum
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
11. 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
Anti Scl70 - anti DNA topoisomerase I antibody
Glucocorticoids
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes
12. What are defining lab findings for polymyalgia rheumatica and What is the TX
Corneum - lucidum - granulosum - spinosum - basalis
Basal cell carcinoma - pearly papules - commonly with telangiectasias
Elevated ESR and nl CK - prednisone
Xeropthalmia - xerostomia - arthritis
13. What causes total claw
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Osteoarthritis
Osteochondroma - exostosis
14. What nerve is injured by a superficial laceration of the hand
In psoriasis - bleeding spots when scales are scraped off
Median nerve
Recurrent branch of the medain nerve
Wheal
15. Depolarizaition causes what voltage sensitive receptor coupled to what other receptor to induce a conformational change In what structure - releasing what?
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Plaque
Median nerve
16. What is contained within epithelial granulomas of pts with sarcoid
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies
Median nerve
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
NSAIDs (indomethacin) colchicine
17. What syndrome of the NMJ is a paraneoplastic syndrome and What are the antibodies directed against
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
HI shrinks - A stays same
Albinism
18. What supplies innervation to the thenar muscles
Papule
Recurrent branch of the median nerve
Radial nerve
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
19. Autoimmune disorder with IgG antibody against hemidesmosomes - dz - IM - other findings
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20. exotoxin destroys keratinocyte attachments in the stratum granulosum - fever - generalized erythematous rash with sloughing of the upper layers of the dermis - newborns and children
Recurrent branch of the medain nerve
Erythema multiforme - can be macules - papules vesicles - target lesions -
Staph scalded skin syndrome
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
21. inflammatory disorder affective synovial joints with pannus formation in joints
Pseudogout
Rheumatoid arthritis
Myosin
Nevocellular nevus
22. Where is C4 dermatome
Over deltoid
Degenerative injury due to repeated use - tiny tears in the tendons and muscles - may be inflammatory - lateral epicondyle is tennis - medial epicondyle is golf
Osteogenic carcinoma
Osteoid osteoma
23. What are the common perpetrating infections for Reiters syndrome
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes
Post GI infxn or chlamydia
Actinic keratosis
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
24. Where does squamous cell carcinoma of the skin typically appear - What is the histo - prognosis - and associations
Osteoporosis
Peroneal everts and dorsiflexes - foot dropPED; tibial inverts and plantarflexes - can't stand on Tip toes
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Axilla
25. knee trauma - nerve - motor and sensory def
Viral - maybe paramyxovirus
Tibial - foot inversioon and plantarflexion; toe flexion - sole of foot is sensory
Ulnar deviation - subluxation - bakers cysts (behind knee)
Ulnar nerve - fracture of hook of hamate
26. fever - bulla formation and necrosis - sloughing of skin and high mortality - syndrome and associations
Parakeratosis
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
Trauma
27. What is the TX for acute gout
Mesenchymal stem cells in periosteum
Osteochondroma - exostosis
NSAIDs (indomethacin) colchicine
B27 - no RF - males
28. What receptor is constitutively activated in achondroplasia and What does it do
In psoriasis - bleeding spots when scales are scraped off
Pemphigus vulgaris
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Dermatomyositis
29. Where is C8 dermatome
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Medial finger flexion - wrist flexion
Medial 1.5 fingers - hypothenar eminence
4th and 5th finger
30. What is the Auspitz sign
In psoriasis - bleeding spots when scales are scraped off
Type 2
Inc CK - inc aldolase - and positive ANA and anti Jo -1 - steroids
Ulnar nerve - intrinsic muscles of hand
31. What lesion causes winged scapula
4th and 5th finger
Gout
Osteoblastoma
Long thoracic nerve
32. hives - intensely pruritic wheals that form after mast cell degranulation
Urticaria
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Corneum - lucidum - granulosum - spinosum - basalis
Phosphate is liberated from the myosin head
33. What is CREST syndrome and What antibody is it associated with
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
Restrictive lung disease - bilateral hilar lymphadenopathy - erythema nodosum - Bell's palsy
34. Contraction results in shortening of what bands - and what band remains the same length
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases
HI shrinks - A stays same
Plaque
Tight jxn - prevents diffusion across paracellular space - composed of claudins and occludins
35. What causes a lesion in the axillary nerve
Fracture of surgical neck - dislocation of the humerus - intramuscular injections
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Osteosarcoma - multiple myeloma
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
36. How does the radial nerve in the spiral groove become injured
Lesioned by midshaft fracture of humerus
Melasma (chloasma)
Ulnar nerve
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
37. Where do sebhorrheic keratosis lesions occur and in who
Men and women > 70 - senile osteporosis
Torn MCL
Head - trunk - extremities - common benign neoplasm in older persons
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
38. appreas in 30s to 40s - does not regress
Acute back pain - loss of height - and kyphosis
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Cherry hemangioma
39. Seronegative spondyloarthropathis have what HLA association - and why are they seronegative - and who do they more often occur in
4th and 5th finger
Integrin binds laminin in BM
B27 - no RF - males
Subclavius
40. Decrease marrow space in osteopetrosis leads to what?
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis
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
Viral - maybe paramyxovirus
41. What causes compression of the C7 nerve root
Actin
Dec Ca - dec phos - nl alk phos - inc PTH - soft bones
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
Cervical disk lesion
42. Through what pathway does NO work and What is the downstream effect
MCL - ACL - lateral meniscus (esp in athletes)
GC and cGMP and inhibition of MLCK
Ulnar nerve
Dec estrogen causes inc bone resorption - postmenopausal
43. What do xray show in osteopetrosis and What do potential CN abnl result from
Erlenmeyer flask bones that flare out - narrowed foramina
Type 1 - inc mitochondria and myoglobin conc - inc OXPHOS leading to sustained conctraction
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Dermatitis herpetiformis
44. What do lumbricals do
Impetigo - s aureus - s pyogenes
Vertebral crush fractures - femoral neck fractures - distal radius (Colles') fracture
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Flex the MCP joints and extend both the DIP and PIP joints
45. Why does EtOH consumption precipitate gout
Chondrosarcoma
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
GC and cGMP and inhibition of MLCK
46. On the palmar and dorsal sides of the hand - what dermatome covers the 5th finger and the lateral 1/2 of the 4th finger
Endochondroma
Ulnar
Phosphate is liberated from the myosin head
Radial nerve becomes compressed in axilla
47. epi of SLE
Verrucae vulgaris
Osteopetrosis - abnl fxn of osteoclasts
Female between 14 and 45 - mostly black
Dermatitis herpetiformis
48. What are the classic fractures in pts with osteoporosis
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49. potentially fatal autoimmune disorder with IgG antibody against desmosomes
Pemphigus vulgaris
Median nerve - same fingers but not on the hand
Trauma
Actinic keratosis
50. Where is osteosarcoma found in the bone
Spindle shaped cells with multinucleated giant cells
Metaphysis of long bones - distal femur
Integrin binds laminin in BM
Dorsal side of lateral hand - most of lateral surface of the thumb - no digits
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