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Musculoskeletal
Pathology: Musculoskeletal
| Question | Answer |
|---|---|
| Osteogenesis imperfecta 1. genetic transmission 2. defect | 1. autosomal dominant 2. defect in synthesis of type 1 collagen |
| Osteopetrosis 1. genetic transmission 2. defect | 1. autosomal recessive 2. carbonic anhydrase II deficiency ➞ defect of osteoclasts ➞ too much brittle bone |
| 1. Fractures at birth and blue sclera 2. What is the mutation seen in achondroplasia? 3. What is main clinical finding? | 1. osteogenesis imperfecta 3. (dwarphism) impairment in endochondral bone formation at the growth plate leads to shortened arms and legs |
| Osteomyelitis 1. most common pathogen 2. pathogen in sickle cell patients 3. tuberculosis that spreads to the vertebral column 4. pathogen after trauma | 1. Staphylococcus aureus 2. Salmonella 3. Pott's disease 4. Pseudomonas aeruginosa |
| 1. What is the cause of postmenopausal osteoporosis? 2. How does this effect bone maintenance? | 1. due to estrogen deficiency 2. ↓ estrogen ↑ osteoclastic resorption and ↓ osteoblastic formation |
| Screening procedures for osteoporosis: | dual-energy x-ray absorptiometry (DEXA) |
| Duchenne vs Becker muscular dystrophy | Duchenne is a complete loss of dystrophin while Becker is incomplete |
| 1. What is osteoarthritis 2. Which joints are most effected? 3. Which type of collagen is articular cartilage? | 1. progressive degeneration of articular cartilage from wear and tear 2. hip, lower lumbar spine, DIP & PIP of fibers, knees 3. Type II |
| Which pathology is known to contain the following in the synovial fluid: 1. Monosodium urate (MSU) 2. Calcium pyrophosphate | 1. gout 2. pseudogout |
| How do the following appear when subjected to polarization: 1. Monosodium urate (MSU) 2. Calcium pyrophosphate | 1. negative birefringence; yellow when parallel to the slow ray, blue when perpendicular 2. positive birefringence; blue when parallel to the slow ray, yellow when perpendicular |
| 1. Normal joint lubricant 2. What secretes this product? | 1. hyaluronic acid 2. synovium that lines the inner joint capsule |
| 1. What is an osteophyte? 2. Osteophytes that form at the DIP joints? 3. Osteophytes that form at the PIP? | 1. reactive bony outgrowth from bone on bone rubbing after cartilage has disappeared 2. Heberden's nodes 3. Bouchard's nodes |
| 1. What is Charcot arthropathy 2. What are the 3 common causes? | 1. loss of proprioception or deep sensation leading to recurrent joint trauma 2. diabetes mellitus, syringomyelia, tabes dorsalis (syphilis) |
| Which hand joints are involved in: 1. Rheumatoid arthritis 2. Osteoarthritis | 1. MCP & PIP 2. DIP & PIP |
| 1. What is Sjogren's syndrome? 2. What are the 3 clinical findings that are common? | 1. autoimmune destruction of minor salivary and lacrimal glands 2. rheumatoid arthritis, keratoconjunctivitis, dry mouth |
| 1. What is a tophus? Common locations 2. spondylitis 3. ankylosing | 1. MSU crystal deposites in soft tissue around joint (olecranon bursa, Achilles tendon) 2. involving the axial skeleton 3. involving fusion of joints |
| 1. Arthritis following a GI or Chlamydial infection 2. What are the most common symptoms? | 1. Reiter's syndrome 2. Urethritis, arthritis, conjunctivitis (Can't see, can't pee, can't climb a tree) |
| 1. Most common cause of septic arthritis 2. Second most common cause | 1. Neisseria gonorrhoeae 2. Staphylococcus aureus |
| Cafe au lait spots, polyostotic fibrous dysplasia, precocious sexual development | McCune-Albright syndrome |
| DDx for joint pain in the morning | 1. rheumatoid arthritis 2. SLE 3. polymyalgia rheumatica |
| 1. Most common bone cancer in teenagers; what does it look like on x-ray 2. Translocation involved in Ewing sarcoma | 1. osteosarcoma; codman's triagnle (elevation of periosteum) 2. 11;22 translocation |
| 1. Joint pain in the morning that worsens throughout the day. 2. Joint pain in the morning that improves with activity | 1. Osteoarthritis 2. Rheumatoid arthritis |
| What is the pathogenesis of Paget disease? | 1. ↑ osteoclastic activity 2. mixed osteoclastic-osteoblastic phase 3. compensatory ↑ in osteoblastic activity resulting in thick, brittle bones |
| 1. Common facial bone tumor? 2. Tumor of bone with an overlying cartilage cap | 1. osteoma (benign) 2. osteochondroma |
| Osteoid osteoma vs osteoblastoma 1. Which responds to aspirin 2. Which arises from long bones 3. Which arises from vertebrae | 1. osteoid osteoma 2. osteoid osteoma 3. osteoblastoma |
| 1. Tumor the may arise from individuals with Paget disease 2. Most common bone tumor of females | 1. osteosarcoma 2. giant cell tumor (osteoclastoma) |
| 1. Which joint is commonly involved in infectious arthritis? 2. Bilateral proximal muscle weakness, malar rash, + ANA, anti-Jo-1 antibody | 1. knee 2. Dermatomyositis |
| Dermatomyositis vs polymyositis 1. involves skin 2. endomysial inflammation 3. perimysial inflammation 4. CD8+ T cells 5. CD4+ T cells | 1. dermatomyositis 2. polymyositis 3. dermatomyositis (perymysium is closer to the skin) 4. polymyositis 5. dermatomyositis |
| Myasthenia gravis vs Lambert-Eaton 1. muscle strength improves with use 2. muscle strength worsens with use 3. paraneoplastic syndrome of small cell carcinoma 4. associated with thymoma | 1. Lambert-Eaton 2. Myasthenia gravis 3. Lambert-Eaton 4. Myasthenia gravis |
| Pathogenesis of: 1. Myasthenia Gravis 2. Lambert-Eaton | 1. autoantibodies against acetylcholine receptor 2. autoantibodies against presynaptic calcium channel |
| 1. Benign tumor of skeletal muscle 2. Malignant tumor of skeletal muscle 3. Most common soft tissue tumor in adults | 1. Rhabdomyoma 2. Rhabdomyosarcoma 3. Lipoma |
| 1. Arthritis following gastroenteritis 2. Which bone deformities have increased ALP? | 1. reactive arthritis (Reiter's syndrome) 2. Paget's disease, osteitis fibrosa cystica |
| 1. tumor most commonly found at the epiphyseal end of long bones 2. benign cartilaginous neoplasm 3. malignant cartilaginous tumor | 1. giant cell tumor (osteoclastoma) 2. enchondroma 3. chondrosarcoma |
| 1. What is rheumatoid factor? 2. Which HLA subtype is associated with rheumatoid arthritis? 3. Which HLA subtype is associated with ankylosing spondylitis? | 1. IgM directed against the Fc portion of IgG 2. HLA-DR4 (MHC II) 3. HLA-B27 (MHC I) |
| Which disease is associated with: 1. Anti-Jo-1 antibodies 2. Anti-SS-A and Anti-SS-B (Anti-Ro and Anti-La) 3. Anti-desmoglein 4. Antihistone | 1. dermatomyositis, polymyositis 2. Sjogren's disease 3. Pemphigus vulgaris 4. Drug-induced lupus |
| 1. autoimmune disorder associated with false positives on VDRL tests 2. Autoimmune disorder associated with anti-centromere antibody 3. Autoimmune disorder associated with anti-topoisomerase I antibody | 1. Systemic lupus erythematosus 2. CREST syndrome 3. Diffuse scleroderma |
| Join pain and stiffness with unilateral headaches. | polymyalgia rheumatica associated with giant cell arteritis |
| 1. Noncaseating granulomas with ↑ serum ACE levels and calcium 2. Why is calcium elevated? | 1. sarcoidosis 2. ↑ macrophage acitivity → ↑IFNγ → ↑1α-hydroxylase |
| 1. muscle pain, periorbital edema, eosinophilia one week after ingestion of undercooked pork 2. pruritic (itchy), erythematous skin disorder that relapses 3. Hypersensitivity reaction following exposure to allergen? Whay type of hypersensitivity is it? | 1. trichinosis 2. atopic dermatitis (eczema) 3. contact dermatitis; type IV |
| 1. Papules and plaques with silver scaling 2. Antibodies against hemidesmosomes 3. Antibodies against desmosomes | 1. psoriasis 2. Bullous pemphigoid 3. Pemphigus vulgaris |
| 1. Normal melanocyte number with ↓ melanin production 2. autoimmune destruction of melanocytes causing depigmentation | 1. albinism 2. vitiligo |
| 1. Superficial skin infection of epidermis. Cause? 2. Infection of dermis and subcutaneous tissues 3. Infection of subcutaneous tissue that spreads along fascial planes | 1. impetigo; S. aureus or S. pyogenes 2. cellulitis; S. aureus or S. pyogenes 3. Necrotizing fasciitis; anaerobic bacteria or S. pyogenes |
| 1. Exotoxin destruction of keratinocyte attachments in the stratum granulosum only. 2. White plaques on tongue of HIV patients | 1. Staphylococcal scalded skin syndrome 2. Hairy leukoplakia EBV mediated |
| 1. Dermatitis herpetiformis is associated with which disease? 2. Separation of epidermis from dermis from drug reaction. What is the more severe form of this disorder? | 1. celiac disease (both involve IgA) 2. Stevens-Johnson syndrome; toxic epidermal necrolysis |
| 1. brown plaques with hyperplasia of stratum spinosum, associated with hyperinsulinemia 2. Red "birthmark" that grows rapidly and regresses 3. Red papule that appears in middle age | 1. Acanthosis nigricans 2. strawberry hemangioma 3. cherry hemangioma |
| 1. precursor to squamous cell carcinoma caused by sun exposure 2. skin cancer with elevated edges and central ulceration 3. skin tumor with significant risk for metastasis | 1. Actinic keratosis 2. basal cell carcinoma 3. melanoma |
| Inherited defect with bone fractures, anemia, thrombocytopenia. | Osteopetrosis; replacement of marrow with bone |
| 1. Tumor arising in the diaphysis of long bones and confused with lymphoma 2. Is myasthenia gravis more comon in men or women? | 1. Ewing sarcoma 2. Women |
| 1. Benign squamous proliferation with 'stuck-on' appearance. Common in elderly. 2. Erythema multiforme is most commonly associated with 3. What is a mole? | 1. seborrheic keratosis 2. HSV 3. (Nevus) benign neoplasm of melanocytes |
| Which bone tumors arise from the: 1. epiphysis 2. metaphysis 3. diaphysis | 1. giant cell tumor 2. osteochondroma, osteosarcoma 3. osteoid osteoma, Ewing sarcoma, enchondroma, chondrosarcoma |
| 1. What is a pannus? 2. What condition exhibits pannus formation? | hyperplastic synovial tissue growing over articular cartilage in rheumatoid arthritis |
| 1. autoimmune skin disorder with bullae in skin and oral mucosa that rupture easily 2. Autoimmune skin disorder with large bullae that do not easily rupture 3. Which condition is more severe? | 1. Pemphigus vulgaris 2. Bullous pemphigoid 3. Pemphigus vulgaris |
| 1. Bone pain and fractures and replacement of marrow caused by hyperparathyroid hormone 2. Patient was receiving glucocorticoids and now has left hip pain? | 1. osteitis fibrosa cystica 2. avascular necrosis |
| 1. Localized pain and swelling of knee, weight loss and anemia 2. What feature of melanoma lesions is prognosis related to | 1. Osteosarcoma 2. depth of invasion |
| Patient with history of Rheumatoid arthritis has splenomegaly and leukopenia. | Fely's syndrome |
| 1. Muscle tissue ossifies during healing after trauma 2. Reactive fibroblast proliferation after trauma | 1. myositis ossificans 2. Nodular fasciitis |
| 1. What causes multiple seborrhetic keratosis? 2. Definition of osteopenia? | 1. Gastric adenocarcinoma (sign of leser Trelat 2. lower than normal bone density; precursor to osteoporosis |
| 1. Elevated skin lesion < 1cm 2. Flat discoloration < 1cm 3. Elevated skin lesion > 1cm 4. Small fluid-containing blister | 1. papule 2. macule 3. plaque 4. vesicle |
| 1. ↑ thickness of stratum corneum 2. Which disorders is this seen in? | 1. hyperkeratosis 2. psoriasis, actinic keratosis |
| What are the symptoms of CREST syndrome? | 1. Calcinosis - calcium deposits in skin 2. Raynaud's phenomenon 3. Esophageal dysfunction - acid reflux 4. Sclerodactyly 5. Telangiectasia - dilation of capillaries |
| Thirty year old with painful muscle cramps and myoglobinuria. | McArdle's disease (noticed in childhood but usually not diagnosed until 3rd decade of life) |
Created by:
amichael87
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