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Test your basic knowledge |
Musculoskeletal
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Study First
Subject
:
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 cancer in particular are associated with LE syndrome - what happens to symptoms with muscle use or ACH esterase inhibs
Intraepidermal bullae involving the skin and oral mucosa
Actin
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Precocious puberty
2. Depolarizaition causes what voltage sensitive receptor coupled to what other receptor to induce a conformational change In what structure - releasing what?
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Median nerve
Radial nerve
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
3. What are the bone mineralization lab findings in osteopetrosis
B27 - no RF - males
Serum ca - phos - alk phos are NL
Men - needle shaped and negatively birefringent = yellow crystals under parallel light
Anterior interosseous nerve
4. What lesion causes Saturday night wrist drop
Radial nerve
After a large meal or EtOH conspumption
Type 2
Loss of lateral lumbrical fxn - 2nd and 3d digits are clawed and can't extend
5. What form of polyostotic fibrous dysplasia has multiple unilateral bones lesions associated with endocrine abnl and unilateral pigmented skin lesions - caf
McCune - Albright syndrome
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Dermatomyositis
6. osteochondrosis has rare malignant transformation into what cancer
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Chondrosarcoma
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
7. progressive symmetric proximal muscle weakness cause by CD8+ T cell induced injury to myofibers - dz - most common area of involvement and pathgnomonic histological finding
Erlenmeyer flask bones that flare out - narrowed foramina
Polymyositis - shoulders - perifasicular inflammation
Steroids
Ulnar
8. What is the precursor to melanom
Dysplastic nevus
Thymoma
Ephelis
Torn MCL
9. What do lupus pts falsely test positive for syphillis
Basophilic - rhomboid crystals - weakly birefringent
Nl - thickened dense bones
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
False positives on syphillis test (RPR/VRDL) due to antiphospholipid antibodies - cross react with cardiolipin
10. premalignant lesions caused by sun exposure - small rough - erythematous or brownish papules - cutaenous horns - Name and risk of carcinoma
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
Fracture of surgical neck - dislocation of the humerus - intramuscular injections
Actinic keratosis - risk proportional to epithelial dysplasia
Teres minor
11. What lesion causes total claw (klumpke's hand)
Urticaria
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis
Lower trunk of brachial plexus
Fever - fatigue - weight loss - nonbacterial verruucous (Liebman - Sacks) endocarditis - hilar adenopathy - Raynauds
12. What is TX for osteoporosis
Asymmetric - swollen - red - painful joint - often MTP (podagra) - tophus formation on external ear - olecranon bursa - achilles tendon
Restrictive lung disease - bilateral hilar lymphadenopathy - erythema nodosum - Bell's palsy
SERMs - calcitonin - bisphosphates or pulsatile PTH for severe cases
Sarcoidosis - black females - ACE
13. What causes total claw
Post GI infxn or chlamydia
Myosin light chain phosphotase
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Adductor policis brevis
14. herald path followed by days later christmas tree distribution - multiple papular eruptions; remits spontaneously
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
Pityriasis rosea
Verrucae vulgaris
15. What do the branches of the deep ulnar nerve innervate
Median nerve
Interossei and adductor policis
Cellulitis - s aureus - s pyogenes
Lesioned by midshaft fracture of humerus
16. inflammatory disorder affective synovial joints with pannus formation in joints
Actin
Degenerative injury due to repeated use - tiny tears in the tendons and muscles - may be inflammatory - lateral epicondyle is tennis - medial epicondyle is golf
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Rheumatoid arthritis
17. Dermatomyositis places the pt at inc risk For what malignancy in particular
Ligand binding leads to muscle depol
Lung
Chondrosarcoma - pelvis - spine - scapula - humerus - tibia - or femur
Femoral - thing flexion and leg extension - anterior thigh and medial leg
18. What is a very specific test for lupus
Anti ds DNA - poor prognosis
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
Posterior hip dislocation - can't jump - climb stairs or rise from seated positions
Serum ca - phos - alk phos are NL
19. which muscle type is fast twitch and why are fibers white
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Condyloma acuminatum - caused by HPV
Lung
20. What injury causes injury to the MC nerve and what motor and sensory defs dose it cause
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Upper trunk compression - biceps - brachialis - corachobrachialis - flexion of arm at elbow - sensory = lateraly forearm
Loss of lateral lumbrical fxn - 2nd and 3d digits are clawed and can't extend
Basophilic - rhomboid crystals - weakly birefringent
21. What are defining lab findings for polymyalgia rheumatica and What is the TX
Chondrosarcoma
Elevated ESR and nl CK - prednisone
Over deltoid
Ankylosing spondylitis - uveitis - aortic regurg and bamboo spine
22. hypothenar eminence - nerve and muscles
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Ulnar deviation - subluxation - bakers cysts (behind knee)
23. MG is associated with what neoplasm
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
Keloid
Thymoma
Acantholysis
24. bening cartilaginous neoplasm found in intramedullary bone - usually distal extremities
Recurrent branch of the median nerve
Vesicle
Endochondroma
Anti ds DNA - poor prognosis
25. Which nerve is compressed in deep forearm
Peroneal everts and dorsiflexes - foot dropPED; tibial inverts and plantarflexes - can't stand on Tip toes
In psoriasis - bleeding spots when scales are scraped off
Anterior interosseous nerve
Female between 14 and 45 - mostly black
26. knee trauma - nerve - motor and sensory def
Intraepidermal bullae involving the skin and oral mucosa
2/3 of the way from the umbilicus to the anterior superior iliac spine - appendix
Nevocellular nevus
Tibial - foot inversioon and plantarflexion; toe flexion - sole of foot is sensory
27. What is the TX for chronic gout
AP depol opens voltage gated Ca channels - inducing NT release
Actinic keratosis - risk proportional to epithelial dysplasia
Radial nerve becomes compressed in axilla
Allopurinaol - uricosurics (probenicid)
28. dried exudates from a vesicle - bulla or pustule seen impetigo
Crust
Squamous cell carcinoma
AP depol opens voltage gated Ca channels - inducing NT release
Boutonniere - swan neck - zthumb
29. What are the characterstic joints affected in RA
Men and women > 70 - senile osteporosis
MCP - PIP - no DIP
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
Making fist with a proximal median nerve lesion
30. hyperkeratosis with retention of nuclei in stratum corneum seen in psoriasis
Parakeratosis
Myasthenia gravis - autoAb against ACH receptors causing ptosis - diplopia - general weakness -
ANA - sensitive but not specific
Median - lateral finger and wrist flexion - dorsal palmar aspects of lateral 3.5 fingers/thenar eminence - ape hand - carpal tunnel syndrome
31. subchondreal cysts - sclerosis - osteophytes - joint space narrowing - eburnation - hebereden's nodes (DIP) bouchard nodes (PIP) - characteristic findings of this dz
Osteoarthritis
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
Radial nerve
Actinic keratosis
32. In smooth muscle contraction - What does Ca bind and What is the purpose
Calmodulin - complex activates myosin light chain kinase
Making fist with a proximal median nerve lesion
Atopic dermatitis - eczema
Pseudogout
33. What is the sign of Leser - Trelat
MCP - PIP - no DIP
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
Sarcoidosis - black females - ACE
34. What are the systemic symptoms found in RA
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
Osteoblastoma
Fever - fatigue - pleuritis - pericarditis
Erythema multiforme - can be macules - papules vesicles - target lesions -
35. Which muscle fiber type is slow twitch and why are fibers red
AP depol opens voltage gated Ca channels - inducing NT release
Condyloma acuminatum - caused by HPV
Type 1 - inc mitochondria and myoglobin conc - inc OXPHOS leading to sustained conctraction
Wheal
36. Where is McBurney's point and What is there
NSAIDs (indomethacin) colchicine
Tear of the ACL
2/3 of the way from the umbilicus to the anterior superior iliac spine - appendix
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
37. What does MLCK do in smooth muscle contraction
Inc spinosum - dec granulosum
Phosphorylates myosin light chain which leads to cross bridge formation
Age - obesity and joint deformity
Medial 1.5 fingers - hypothenar eminence
38. 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...
Ulnar deviation - subluxation - bakers cysts (behind knee)
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
Albinism
39. How is chondrosarcoma described
Expansile glistening mass within the medullary cavity
Spindle shaped cells with multinucleated giant cells
Elevated ESR and nl CK - prednisone
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
40. What kind of endocrine abnl are associated with McCune Albright
Precocious puberty
Macule
Dermatomyositis
Intermediate jxn - just below zona occludens - cadherins and actin filaments - cadherins are dependent on Ca2+
41. Which muscle laterally rotates and adducts arm
Fever - fatigue - pleuritis - pericarditis
Macule
Pseudogout
Teres minor
42. What autoantibodies are formed in sjogrens syndrome
Ribonucleoprotein antigents - SS- A and SS- B (Ro and La)
Head - trunk - extremities - common benign neoplasm in older persons
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
Crust
43. common mole - benign
Allopurinaol - uricosurics (probenicid)
Axilla
Nevocellular nevus
Obturator - thigh adduction - medial thigh
44. What are the characteristic bone findings in paget's disease
The dermis
Acanthosis
Mosiac bone pattern - long bone chalk stick fractures - increased hat size or hearing loss due to auditory foramen narrowing
Large goints (knee)
45. What are the common perpetrating infections for Reiters syndrome
Pain in weight bearing joints at the end of the day and improving with rest
Actin
Post GI infxn or chlamydia
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes
46. Through what pathway does NO work and What is the downstream effect
Chondrosarcoma - pelvis - spine - scapula - humerus - tibia - or femur
Supraspinatus - infraspinatus - teres minor - subscapularis - SItS
Macule
GC and cGMP and inhibition of MLCK
47. What are the associations for sjogrens syndrome
ACH esterase inhibitors - edrophonium test - improvement of sx after edro means the patient is underdosed
Urticaria
Macule
Parotid enlargement - inc risk of B cell lymphoma - dental caries
48. What medication is contraindicated in osteoporosis
Ulnar - opponens digiti minimi - abductor digiti minimi - flexor digiti mimini
Degenerative injury due to repeated use - tiny tears in the tendons and muscles - may be inflammatory - lateral epicondyle is tennis - medial epicondyle is golf
Osteoporosis
Glucocorticoids
49. pruritic eruption - commonly on skin flexures - of associated with asthma - allergic rhinitis
Sites of tibial attachment
Atopic dermatitis - eczema
MCL - ACL - lateral meniscus (esp in athletes)
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis
50. What are the bone mineral lab findings in paget's disease
Papule
Muslce use - nerve stim/compound muscle test
Serum ca - phos - PTH are nl alk phos elevated
< 2mc found in proximal tibia and femur - men < 25
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