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. What are characteristic findings of gout
TB from dissemination and lyme dz
Vesicle
Asymmetric - swollen - red - painful joint - often MTP (podagra) - tophus formation on external ear - olecranon bursa - achilles tendon
S. aureus - streptococcus

2. What is the classic presentation of RA
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
Parakeratosis
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases

3. What is the clinically important landmark for pubendal nerve block and When is it used
Ischial spine - relieve pain during delivery
Seborrheic keratosis
NSAIDs (indomethacin) colchicine
Nevocellular nevus

4. What are the bone mineralization lab findings in osteopetrosis
Serum ca - phos - alk phos are NL
Myosin light chain phosphotase
Acute back pain - loss of height - and kyphosis
Inc blood flow from AV shunts can cause high output heart failure

5. Macule greater than 1cm
Patch
MCL - ACL - lateral meniscus (esp in athletes)
Ulnar nerve - fracture of hook of hamate
Median nerve - lunate bone

6. What lesion causes difficulty flexing elbow with variable sensory loss
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
Musculocutaneous
Crohns and ulcerative colitis
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid

7. What are the predisposing factors for osteoarthritis
Onion skin - 11:22 - diaphysis of long bones - pelvis - scapula - ribs
Age - obesity and joint deformity
Renal - pulm - CV - GI - 75% female
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid

8. immune mediated - widespread - non - caseating granulomas - dz - affected population and elevated serum level
Dermatomyositis
Verrucae
Pseudogout
Sarcoidosis - black females - ACE

9. How does the radial nerve in the spiral groove become injured
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit
Cherry hemangioma
Lesioned by midshaft fracture of humerus
Ischial spine - relieve pain during delivery

10. In a fractured surgical neck of humerus or dislocation of humeral head - What is the nerve injury - motor deficit - sensory deficit
Osteosarcoma - multiple myeloma
Serum ca - phos - alk phos are NL
3rd finger
Axillary - deltoid - skin over deltoid - flattened deltoid

11. What syndrome of the NMJ is a paraneoplastic syndrome and What are the antibodies directed against
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Ulnar nerve
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
Renal - pulm - CV - GI - 75% female

12. What are the possible origins of the paget's disease
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop
Myosin releases bound ADP and is displaced on the actin filament
Ligand binding leads to muscle depol
Viral - maybe paramyxovirus

13. What is the test for drug induced lupus
Large goints (knee)
Peroneal everts and dorsiflexes - foot dropPED; tibial inverts and plantarflexes - can't stand on Tip toes
Anti - histone
Nl - decreased bone mass

14. subchondreal cysts - sclerosis - osteophytes - joint space narrowing - eburnation - hebereden's nodes (DIP) bouchard nodes (PIP) - characteristic findings of this dz
Carbonic anhydrase II
Hyperkeratosis
Dorsal side of lateral hand - most of lateral surface of the thumb - no digits
Osteoarthritis

15. What is the source of osteoblast cells
Radial nerve becomes compressed in axilla
Urticaria
Mesenchymal stem cells in periosteum
Opposition of thumb - dorsal/palmar 3.5 fingers sensory - ulnar deviation upon wrist flexion

16. What is the sign of Leser - Trelat
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid
Serum ca - phos - PTH are nl alk phos elevated
Antibodies around cells of the epidermis in a reticular or netlike pattern

17. What enzyme is necessary for smooth muscle relaxation after contraction
MCL - ACL - lateral meniscus (esp in athletes)
Mesenchymal stem cells in periosteum
Pseudogout
Myosin light chain phosphotase

18. interlacing trabeculae of woven bone surrounded by osteoblasts
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Boutonniere - swan neck - zthumb
Erythema nodosum
Osteoid osteoma

19. What is contained within epithelial granulomas of pts with sarcoid
Middle bicep down - cuts lateral at cuboidal foass and runs distally to include the thumb and 2nd digit
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies
Musculocutaneous
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)

20. When does membranous ossification occur and What is the difference between membranous and endochondrial
Pagets dz - bone infarcts - radiation - familial retinoblastoma - codman's triangle or sunburst pattern from elevation of periosteum - poor prognsosis
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
Recurrent branch of the medain nerve

21. Where is C7 dermatome
HI shrinks - A stays same
Lesioned by midshaft fracture of humerus
3rd finger
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar

22. Patients with pagets disease can develop what cancer
Recurrent branch of the medain nerve
Staph scalded skin syndrome
Osteogenic carcinoma
3rd finger

23. What are the lab findings in osteopetrosis
Chondrosarcoma
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
Nl - thickened dense bones
Steroids

24. Achondroplasia is a failure of what process which results in which characteristic findings
Failure of longitudinal growth (endochondrial ossification) leading to short limbs - membranous is unaffected - large head
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Seborrheic keratosis
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup

25. What nerve is injured in a posterior hip dislocation or polio and What are the motor defs
Inc blood flow from AV shunts can cause high output heart failure
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
Men and women > 70 - senile osteporosis
Median nerve

26. mechanical wear and tear of joints leading to destruction of articular cartilage
3rd finger
Biceps
Osteoporosis
Osteoarthritis

27. fever - bulla formation and necrosis - sloughing of skin and high mortality - syndrome and associations
Actinic keratosis
Carbonic anhydrase II
Nevocellular nevus
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis

28. What medication is contraindicated in osteoporosis
Paralysis of lateral rotators
Paralysis of abductors
Glucocorticoids
GC and cGMP and inhibition of MLCK

29. Where is C4 dermatome
Over deltoid
Dec estrogen causes inc bone resorption - postmenopausal
Subclavius
Polyostotic fibrous dysplasia

30. What is a very specific test for lupus
Lesioned by midshaft fracture of humerus
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
Anti ds DNA - poor prognosis
Osteoarthritis

31. transiet vesicle seen in hives
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Wheal
Recurrent branch of the medain nerve
4th and 5th finger

32. How is chondrosarcoma described
Supraspinatus - abducts the arm before the deltoid
Calmodulin - complex activates myosin light chain kinase
Median nerve
Expansile glistening mass within the medullary cavity

33. Trauma to lateral aspect of leg or fibula neck fracture - nerve - motor and sens def
Long thoracic nerve
Steroids
Obturator - thigh adduction - medial thigh
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory

34. Thenar eminence - nerve and muscles
Long thoracic nerve
85% - advanced paternal age - or auto dominant inheritance
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
Intraepidermal bullae involving the skin and oral mucosa

35. appreas in 30s to 40s - does not regress
TB from dissemination and lyme dz
Type 2
Cherry hemangioma
Xeropthalmia - xerostomia - arthritis

36. What clinical features in vertebral crush fractures
Connects cells to underlying extracellular - bullous pemphigoid
Acute back pain - loss of height - and kyphosis
Age - obesity and joint deformity
Long thoracic nerve

37. What causes compression of the C7 nerve root
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Viral - maybe paramyxovirus
Radial nerve becomes compressed in axilla
Cervical disk lesion

38. 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
Fracture of surgical neck - dislocation of the humerus - intramuscular injections
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Fever - fatigue - weight loss - nonbacterial verruucous (Liebman - Sacks) endocarditis - hilar adenopathy - Raynauds
Bulla

39. What is the sensory def of an ulnar nerve injury
85% - advanced paternal age - or auto dominant inheritance
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
Medial 1.5 fingers - hypothenar eminence
Long thoracic nerve

40. Where is osteosarcoma found in the bone
Metaphysis of long bones - distal femur
Recurrent branch of the medain nerve
Axillary - deltoid - skin over deltoid - flattened deltoid
Medial forearm and arm to just under the axilla

41. What causes ape hand
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Outer arm
Mesenchymal stem cells in periosteum

42. What is a precursor to squamous cell carcinoma
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
Outer arm
Actinic keratosis
Precocious puberty

43. Contraction results in shortening of what bands - and what band remains the same length
Radial nerve becomes compressed in axilla
Hairy leukoplakia - HIV population - EBV mediated
Outer arm
HI shrinks - A stays same

44. Other than N. gono - what organisms can cause infectious - septic arthritis
Albinism
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
S. aureus - streptococcus

45. Loss of what muscles in Erbs causes the forearm to be pronated
Biceps
HI shrinks - A stays same
Keloid
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages

46. Loss of what muslces in Erbs causes the limb to hang by side
Musculocutaneous
Rigor mortis
Paralysis of abductors
Pemphigus vulgaris

47. What kind of nuclei do basal cell tumors have
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases
Palisading
Antibodies around cells of the epidermis in a reticular or netlike pattern
Wheal

48. What nerve controls ab and adduction of the interossei muscles and What does it for the thumb and 4th and 5th lumbricals
Actin
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen

49. What receptor is constitutively activated in achondroplasia and What does it do
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Boutonniere - swan neck - zthumb
Deep branch of radial nerve
NSAIDs (indomethacin) colchicine

50. What lesion causes Saturday night wrist drop
Albinism
Wheal
Crohns and ulcerative colitis
Radial nerve