Test your basic knowledge |

Musculoskeletal

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 molecule maintatins integrity of basement membrane and What does it bind
Integrin binds laminin in BM
Osteosarcoma - multiple myeloma
Intraepidermal bullae involving the skin and oral mucosa
Anemia - thrombocytopenia - infection - extramedullary hematopoiesis

2. What receptor is constitutively activated in achondroplasia and What does it do
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Making fist with a proximal median nerve lesion
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling

3. IBS - 2 dz's
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
Crohns and ulcerative colitis
Vesicle
MCP - PIP - no DIP

4. What antibodies is diffuse scleroderma associated with
Head - trunk - extremities - common benign neoplasm in older persons
Median nerve - lunate bone
Outer arm
Anti Scl70 - anti DNA topoisomerase I antibody

5. What nerve is compressed by supracondylar fracture of humerus
Median nerve
Wire - loop lesions in kidney with immune complex deposition - death from renal failure and infxns
Pemphigus vulgaris - macula adherens where cadherins attach to intermediate filaments
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis

6. What are the characteristic bone findings in paget's disease
Mosiac bone pattern - long bone chalk stick fractures - increased hat size or hearing loss due to auditory foramen narrowing
Interossei and adductor policis
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Phosphorylates myosin light chain which leads to cross bridge formation

7. What protects the brachial plexus in clavicle fracture
Median nerve
Melasma (chloasma)
Subclavius
In psoriasis - bleeding spots when scales are scraped off

8. What is the Sicca syndrome
Dry eyes - dry mouth - nasal and vaginal dryness - chronic bronchitis - reflux esophagitis and No arthritis
McCune - Albright syndrome
3rd finger
Pemphigus vulgaris

9. What happens in the power stroke of skeletal muscle contraction
2/3 of the way from the umbilicus to the anterior superior iliac spine - appendix
Phosphate is liberated from the myosin head
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Steroids

10. How does the radial nerve in the spiral groove become injured
Ulnar deviation - subluxation - bakers cysts (behind knee)
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Lesioned by midshaft fracture of humerus
Anti - histone

11. In which gender is gout more common and What does the crystals appear like microscopically
Men - needle shaped and negatively birefringent = yellow crystals under parallel light
Teres minor
Down T tubule
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup

12. What is the TX for chronic gout
Palisading
Staph scalded skin syndrome
Allopurinaol - uricosurics (probenicid)
Atopic dermatitis - eczema

13. What kind of nuclei do basal cell tumors have
Anterior interosseous nerve
Thymoma
Palisading
Paralysis of abductors

14. 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
Medial finger flexion - wrist flexion
Intraepidermal bullae involving the skin and oral mucosa
Biceps

15. What are the lab findings in osteomalacia/rickets
HI shrinks - A stays same
Dec Ca - dec phos - nl alk phos - inc PTH - soft bones
Connects cells to underlying extracellular - bullous pemphigoid
Tear of the ACL

16. 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
Medial aspect
Polymyositis - shoulders - perifasicular inflammation
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+

17. normal melanocyte number with dec melanin production due to inactivity of tyrosine
3rd finger
Proximal median nerve lesion - loss of opponens pollicis muscle fxn leading to unopposoble thumb
Albinism
Iliac crest

18. What happens at the gap jxn and what molecules create them
After a large meal or EtOH conspumption
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
Ulnar nerve
Myosin

19. What organisms can cause chronic infectious arthritis
Lung
TB from dissemination and lyme dz
Medial aspect
Intraepidermal bullae involving the skin and oral mucosa

20. What cancer in particular are associated with LE syndrome - what happens to symptoms with muscle use or ACH esterase inhibs
Vit D def - dec Ca - inc PTH - dec serum phos - reversible when vit D is replaced
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Erythema nodosum

21. What lesion causes wrist drop
Posterior cord
Ewings sarcoma - aggressive with early mets - but responsive to chemo
Femoral - thing flexion and leg extension - anterior thigh and medial leg
Plaque

22. How is chondrosarcoma described
Supraspinatus - abducts the arm before the deltoid
Wheal
Expansile glistening mass within the medullary cavity
Polyostotic fibrous dysplasia

23. yellow when perpendicular and blue when parallel
Large goints (knee)
Pseudogout
ANA - sensitive but not specific
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity

24. What associations go along with sarcoidosis

25. Associated with M. pneumonia - HSV - sulfa drugs - B lactams - phenytoin - cancers and autoimmune dz - skin disorder and description
Nl - decreased bone mass
Lung
Cherry hemangioma
Erythema multiforme - can be macules - papules vesicles - target lesions -

26. pruritic - purple - polygonal papules - sawtooth infiltrate of lymphocytes at dermal - epidermal jxn - associated with hep C
Medial aspect
Lichen planus
Abduct the fingers
Carbonic anhydrase II

27. Damage to what 3 structures is common for the unhappy triad
Medial forearm and arm to just under the axilla
Verrucae vulgaris
MCL - ACL - lateral meniscus (esp in athletes)
Muslce use - nerve stim/compound muscle test

28. inflammatory disorder affective synovial joints with pannus formation in joints
Nevocellular nevus
Rheumatoid arthritis
Median nerve - lunate bone
Dermatomyositis

29. deep tissue injury - crepitus from methane and CO2 production 'flesh eating bacteria' - condition and orgs
Pseudogout
Down T tubule
Necrotizing fasciitis - anaerobic bacteria or S. pyogenes
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema

30. What TX prophylax against osteoporisi
Sarcoidosis - black females - ACE
Post GI infxn or chlamydia
Medial finger flexion - wrist flexion
Exercise and Ca ingestion before age 30

31. hyperpigmentation associated with pregnancy or OCP
Melasma (chloasma)
Median nerve
Serum ca - phos - PTH are nl alk phos elevated
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign

32. What nerve is compressed in carpal tunnel syndrome or a disclocation of this bone
Median nerve - lunate bone
Median nerve
Voltage sens - dihydropiridine R coupled to ryanodine recpetor - conformational change in the SR - releasing Ca2+
Phosphate is liberated from the myosin head

33. hyperkeratosis with retention of nuclei in stratum corneum seen in psoriasis
Dec Ca - dec phos - nl alk phos - inc PTH - soft bones
Condyloma acuminatum - caused by HPV
Vitiligo - dec number in melanocytes
Parakeratosis

34. What is contained within epithelial granulomas of pts with sarcoid
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies
Thymoma
Chondrosarcoma
Urticaria

35. What kind of hypersens rxn is RA - and what serum marker is present in 80% of RA pts
Type III - RF
Over deltoid
Lesioned by midshaft fracture of humerus
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis

36. Loss of what muscles in Erbs causes the forearm to be pronated
Biceps
Psoriatic arthritis - occurs is less than 1/3 of psoriasis pts
Osteoid osteoma
Iliac crest

37. What nerve become injured in the incorrect use of a crutch
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Radial nerve becomes compressed in axilla
Head - trunk - extremities - common benign neoplasm in older persons
Ribonucleoprotein antigents - SS- A and SS- B (Ro and La)

38. Sarcoid TX
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
Pityriasis rosea
Tear of the ACL
Steroids

39. What causes a lesion in the axillary nerve
Erlenmeyer flask bones that flare out - narrowed foramina
Fracture of surgical neck - dislocation of the humerus - intramuscular injections
Pemphigus vulgaris
Hyperkeratosis

40. What are the characterstic joints affected in RA
Dermatitis herpetiformis
Viral - maybe paramyxovirus
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
MCP - PIP - no DIP

41. What are the predisposing factors for osteoarthritis
Age - obesity and joint deformity
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Pseudogout
Femoral - thing flexion and leg extension - anterior thigh and medial leg

42. What are the thin lines along the Z line
Actin
Trauma
Osteogenic carcinoma
Myosin light chain phosphotase

43. What are the systemic symptoms found in RA
Posterior cord
Steroids
Asymmetric - swollen - red - painful joint - often MTP (podagra) - tophus formation on external ear - olecranon bursa - achilles tendon
Fever - fatigue - pleuritis - pericarditis

44. Where is McBurney's point and What is there
2/3 of the way from the umbilicus to the anterior superior iliac spine - appendix
Ulnar deviation - subluxation - bakers cysts (behind knee)
Schaumann (calcium and protein inclusions inside Langhans giant cells) and asteroid bodies
Dermatitis herpetiformis

45. elevated skin lesion <1cm seen in acne vulgaris
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
Papule
Down T tubule
Median nerve - same fingers but not on the hand

46. What are predisposing factors for osteosarcoma - xray finding

47. What does abnl passive abduction of the knee indicate
Myosin light chain phosphotase
Binds troponin C causing a conformational change leading to tropomyosin to move out of the way allowing for actin/myosin cycling
Female between 14 and 45 - mostly black
Torn MCL

48. What are the potential causes of gout

49. warts on hands
Lesch - nyhan - PRPP excess - dec exretion of uric acid (thiazide) inc cell turnover - von Gierke's dz - 90% due to underexcretion - 10% to overproduction
Interossei and adductor policis
Dermatitis herpetiformis
Verrucae vulgaris

50. What is a positive Nikolsky's sign
Anti Smith
Muslce use - nerve stim/compound muscle test
GC and cGMP and inhibition of MLCK
In pemphis vulgaris - separation of epidermis upon manual stroking of skin