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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 does acantholysis show in pemphigus vulgaris
HI shrinks - A stays same
Basal cell carcinoma - pearly papules - commonly with telangiectasias
Intraepidermal bullae involving the skin and oral mucosa
Urticaria
2. pruritic papules and vesicles - deposits of IgA a the tips of dermal papillae - associated with celiac
Dermatitis herpetiformis
Rheumatoid arthritis
Polymyaglia rheumatica associated with temporal (giant cell) arteritis
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
3. Where does the muscle contraction travel after leaving the motor end plate
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages
Superior glut - thigh abduction - pos trendelenburg - hip drops when standing on the opposite foot (standing on the side of the lesion)
Ulnar nerve - adduction of thumb - extension of 4th and 5th fingers (lumbricals)
Down T tubule
4. Why does EtOH consumption precipitate gout
Bulla
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
Anti ds DNA - poor prognosis
Atopic dermatitis - eczema
5. Patients with pagets disease can develop what cancer
Anti Smith
Iliac crest
Osteogenic carcinoma
Inc spinosum - dec granulosum
6. What are the predisposing factors for osteoarthritis
NC migration
Age - obesity and joint deformity
Serum ca - phos - alk phos are NL
Patch
7. hyperplasia of stratum spinosum - associated with hyperinsulinemia (cushings - DM) and visceral malignancy
Connects cells to underlying extracellular - bullous pemphigoid
Dysplastic nevus
Anti ds DNA - poor prognosis
Acanthosis nigcricans
8. How does gonococcal arthritis present
Precocious puberty
STD presents as a monarticular - migratory arthritis with an asynmetrical pattern - affected joint is painful - red and swollen
Men - needle shaped and negatively birefringent = yellow crystals under parallel light
Pustule
9. What do dorsal interosseous muscles do
Defective mineralization/calcification of osteoid - osteomalacia in adults and ricketts in kids
Sudden appearance of multiple sebhorrheic keratosis lesions indicating underlying lesions - GI or lymphoid
Abduct the fingers
Fever - fatigue - pleuritis - pericarditis
10. What lesion causes total claw (klumpke's hand)
Blow to the shoulder - trauma during delivery; limb hangs by side - medially rotated - forearm is pronated
Radial nerve
Lower trunk of brachial plexus
Stevens johnson syndrome - associated with adverse drug reactions - more severe version called toxic epidermal necrolysis
11. What other muscle in the thenar eminence adducts the thumb
Acute back pain - loss of height - and kyphosis
Patch
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Adductor policis brevis
12. What are the thin lines along the Z line
Actin
Upper trunk of brachial plexus
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Paralysis of lateral rotators
13. What nerve is compressed by supracondylar fracture of humerus
Pemphigus vulgaris
NC migration
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
Median nerve
14. What are characteristic findings of gout
Asymmetric - swollen - red - painful joint - often MTP (podagra) - tophus formation on external ear - olecranon bursa - achilles tendon
Ribonucleoprotein antigents - SS- A and SS- B (Ro and La)
Age - obesity and joint deformity
Median - opponens pollicis - abductors pollicis brevis - flexor pollicis brevis
15. What lesion causes difficulty flexing elbow with variable sensory loss
TB from dissemination and lyme dz
Musculocutaneous
Type 2 - dec mitochondria and myoglobin - inc anaerobic glycolysis
Psoriasis
16. What nerve is injured by a fracture of the epicondyle of humerus or repeated minor traumas
Ulnar nerve
Acanthosis nigcricans
False positives on syphillis test (RPR/VRDL) due to antiphospholipid antibodies - cross react with cardiolipin
Ephelis
17. What causes heart failure in with Paget's disease
Inc blood flow from AV shunts can cause high output heart failure
Binds myosin head and releases actin filament allowing cross - bridge cycling and shortening to occur
After a large meal or EtOH conspumption
Boutonniere - swan neck - zthumb
18. What are the histo findings in an osteoclastoma
Spindle shaped cells with multinucleated giant cells
Type III - RF
Pemphigus vulgaris
Ephelis
19. excessive fibrosis and collagen deposition throughout the body - common in skin manifesting as puffy taut skin with absence of wrinkles
Elevated 1 alpha hydroxylase mediated vit D activation in epithloid macrophages
Osteogenic carcinoma
Ischial spine - relieve pain during delivery
Scleroderma
20. 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
Ulnar nerve - intrinsic muscles of hand
ANA - sensitive but not specific
NSAIDs (indomethacin) colchicine
21. When does membranous ossification occur and What is the difference between membranous and endochondrial
Musculocutaneous
Osteogenic carcinoma
Flat bone (skul - facial bones - axial skeleton) woven directly formed - no cartilage - later remodeled to lamellar
< 2mc found in proximal tibia and femur - men < 25
22. What causes a lesion in the upper trunk of the brachial plexus
Trauma
Ulnar nerve
TB from dissemination and lyme dz
Osteoarthritis
23. In longitudinal bone growth - what model is made first (and By what cell) and What is it later replaced by (and By what cells) - process name
Radial nerve becomes compressed in axilla
Anti - CCP - HLA- DR4
Cartilaginous by chondrocytes first - osteoclasts and osteoblasts later replace with women bone and remodel to lamellar bone - endochondrial ossification
Muslce use - nerve stim/compound muscle test
24. How is the lower trunk of the brachia plexus injured and what results from it
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25. What lesion causes dec in thumb fxn 'ape hand'
Median nerve
Deep branch of radial nerve
Radial - BEST extensors - posterior arm and dorsal hand/thumb - wrist drop
Acanthosis nigcricans
26. Which muscle laterally rotates and adducts arm
Paralysis of lateral rotators
Down T tubule
Hyperkeratosis
Teres minor
27. skin cancer associatd associated with excessive exposure to sunlight and arsenic
Gout
Squamous cell carcinoma
Acantholysis
S. aureus - streptococcus
28. What syndrome of the NMJ is a paraneoplastic syndrome and What are the antibodies directed against
Dec estrogen causes inc bone resorption - postmenopausal
Lamber eaton - presynaptic Ca channels - dec ACH release leading to proximal muscle weakness
Pustule
Radial nerve becomes compressed in axilla
29. heliotrope rash 'shawl and face' rash - Gotton's papules - 'mechanic's hands'
Pagets dz - bone infarcts - radiation - familial retinoblastoma - codman's triangle or sunburst pattern from elevation of periosteum - poor prognsosis
Impetigo - s aureus - s pyogenes
EtOH metabolites compete for same excretion site in kidney as uric acid - causing dec uric acid secretion and subsequent buildup
Dermatomyositis
30. What lesions causes Erb's palsy
In pemphis vulgaris - separation of epidermis upon manual stroking of skin
Calmodulin - complex activates myosin light chain kinase
Upper trunk of brachial plexus
Anti Scl70 - anti DNA topoisomerase I antibody
31. exotoxin destroys keratinocyte attachments in the stratum granulosum - fever - generalized erythematous rash with sloughing of the upper layers of the dermis - newborns and children
Xeropthalmia - xerostomia - arthritis
Staph scalded skin syndrome
Condyloma acuminatum - caused by HPV
Corneum - lucidum - granulosum - spinosum - basalis
32. inflammatory disorder affective synovial joints with pannus formation in joints
Plaque
Rheumatoid arthritis
Female between 14 and 45 - mostly black
Serum ca - phos - PTH are nl alk phos elevated
33. What supplies innervation to the thenar muscles
Dry eyes - dry mouth - nasal and vaginal dryness - chronic bronchitis - reflux esophagitis and No arthritis
Recurrent branch of the median nerve
Biceps
Connects cells to underlying extracellular - bullous pemphigoid
34. What is the source of osteoblast cells
GC and cGMP and inhibition of MLCK
Mesenchymal stem cells in periosteum
Gout
Metaphysis of long bones - distal femur
35. What receptor is constitutively activated in achondroplasia and What does it do
Inc spinosum - dec granulosum
Anti Scl70 - anti DNA topoisomerase I antibody
Allows adjacent cells to communicate for electric and metabolic fxns - connexons
Fibroblast growth factor receptor (FGFR3) inhibits chondrocyte proliferation
36. IBS - 2 dz's
Crohns and ulcerative colitis
Ulnar
Loss of lateral lumbrical fxn - 2nd and 3d digits are clawed and can't extend
Elevated ESR and nl CK - prednisone
37. What is a very specific test for lupus
Median - lateral finger and wrist flexion - dorsal palmar aspects of lateral 3.5 fingers/thenar eminence - ape hand - carpal tunnel syndrome
Anti ds DNA - poor prognosis
Over deltoid
Dermatitis herpetiformis
38. fracture of a supracondylar humerus - nerve - motor - sensory - sign and more distal lesion causing the same nerve
Trauma
Sarcoidosis - black females - ACE
Ulnar nerve
Median - lateral finger and wrist flexion - dorsal palmar aspects of lateral 3.5 fingers/thenar eminence - ape hand - carpal tunnel syndrome
39. papules and plaques with silvery scaling - especially on knees and elbows - acanthosis with parakeratotic scaling (nuclei sill in stratun corneum - nail pitting and arthritis
Psoriasis
Impetigo - s aureus - s pyogenes
Plaque
Giant cell tumor (osteoclastoma) - double bubble or soap bubble
40. bone replaced by fibroblasts and irregular bony trabeculae affecting many bones
Femoral - thing flexion and leg extension - anterior thigh and medial leg
Polyostotic fibrous dysplasia
Small cell cancer of the lung - improve with muscle use - no change with ACHE inhibs
Axilla
41. locally invasive but rarely mets skin cancer - rolled edges - with central ulceration - cancer and gross path
Basal cell carcinoma - pearly papules - commonly with telangiectasias
Calcinosis - raynauds - esophageal dysmotility - sclerodactyly - telangiectasia - anti centromere antibody
Common peroneal - foot eversion and dorsiflexion - toe extention - foot drop - foot slap - stepped gaint - anterolateral leg and dorsal aspect of foot for sensory
Osteochondroma - exostosis
42. What kind of nuclei do basal cell tumors have
Palisading
Radial nerve becomes compressed in axilla
Strawberry hemangioma
Loss of lateral lumbrical fxn - 2nd and 3d digits are clawed and can't extend
43. In which joints does pseudogout typically occur
Immunoglobulins - malar rash - discoid rash - ANA - mucositis (oropharyngeal ulcers) - neurologic disorders - serositis (pleuritis - pericarditis) - hematologic disorders - arthritis - renal - photosensitivity
Serratus anterior - connects scapular to thoracic cage - abduction above horizontal position - injured in mastectomy - winged scapula and lymphedema
Acute back pain - loss of height - and kyphosis
Large goints (knee)
44. What happens at the postsynaptic motor end plate
Ligand binding leads to muscle depol
Integrin binds laminin in BM
Psoriasis
Erlenmeyer flask bones that flare out - narrowed foramina
45. What does IM reveal in pemphigus vulgaris
Bullous pemphigoid - linear immunofluorescence - eosinphils within blisters - similar to but less severed thatn pemphigus vulgaris - spares oral mucosa - negaitve nikolsky's sign
Antibodies around cells of the epidermis in a reticular or netlike pattern
Medially rotates and adducts arm
Osteoma (gardners syndrome) - new piece of bone grows on another bone - often skull
46. What are the signs of ulnar nerve injury
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47. What associations go along with sarcoidosis
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48. What is the classic presentation of RA
Lesion to lower trunk of brachial plexus - loss of fxn of all lumbricals - forearm finger flexors - finger extensors are unopposed (radial nerve)
Morning stiffness for > 30 min improving with use - symmetry - systemic sx
Inc Ca - dec phos - inc alk phos - inc PTH - brown tumors
Ewings sarcoma - aggressive with early mets - but responsive to chemo
49. What are the layers of of the epidermis from surface to base
GC and cGMP and inhibition of MLCK
Sites of tibial attachment
Corneum - lucidum - granulosum - spinosum - basalis
Papule
50. What variant of squamous cells carcinoma of the skin grows rapidly and regresses spontaneously
Keratoacanthoma
Anti Scl70 - anti DNA topoisomerase I antibody
Recurrent branch of the medain nerve
Hands and face - ulcerative red lesion - locally invasive bur rare metastasis - associated with chronic draining sinuses and keratin pearls
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