jdlevenson's version from 2015-06-19 21:02


Question Answer
Androgens cause acne howFollicular epidermal HP and excessive sebum production, promoting acne development
Acne pathology 4 components1. Follicular epidermal hyperplasia 2. Excessive production of sebum 3. Inflammation 4. P. Acnes. DHT promotes #1 and 2.
What drugs cause acneEGFR inhibitors and Lithium
Chewing tobacco a/wDental carries, gingivitis, leukoplakia and oral cancer
Does sweating cause acneExacerbates but does not cause
Psoriasis causes arthritis but notMyopathy
Patients who develop dermatomyositis should be evaluated forMalignancy and in particular GI malignancy.
Difficulty climbing stairs, rising from a sitting position and combing their hairDermatomyositis
Gottron papulesred or violaceous flat-topped papules with a light scale that appear over bony prominences; dermatomyositis; often accompanied by heliotrope rash, erythematous or violaceous edematous eruption on the upper eyelids and periorbital skin. Gottron + helitrope rash are specific for dermatomyositis.
Fibromyalgia lab findingsNormal acute phase reactants and other inflammatory markers
Fibromyalgia physical examMultiple tender points at characteristic locations but absence of joint or muscle inflammation
Fibromyalgia symptomsWidespread MSK pain in association with fatigue and neuropsychiatric disturbanes – paresthesias, poor sleep, depression, difficulty concentrating; most common in women age 20-55.
Musculocutaneous, C5-C7, upper arm flexors (biceps, coracobrach and brachialis) and then what sensoryLateral cutaneous nerve of fore arm/ LATERAL FOREARM
Posterior arm sensationRadial nerve
Posterior forearm sensationRadial nerve
Medial forearmUlnar nerve
Thenar eminenceMedian nerve
Erector spinae functionContraction -> spine extension
Support to abdomen during respirationTransverse abdominis; deep to internal oblique
Femoral head blood supplyMedial femoral circumflex; injury to it causes avascular necrosis. Also blood from superior and inferior gluteal arteries forming trochanteric anastomosis. Mostly medial circumflex. Closely associated wirth posterior aspect of neck, hence vulnerability.
Anterior shoulder dislocationDeltoid flattening; usually from foreceful external rotation and abduction at the shoulder joint; axillary nerve damage is associated
Rotator cuff injuries do not involveNerve injury
Fracture of coracoid usually only inShotgun sports
Falling on outstretched hand -> torsion -> midhumerus fracture nerve damage to
Radial nerve. Swelling, crepitus, etc.
Question Answer
Clavicular fractures affect which partMiddle clavicle
Medial aspect of left leg lost whenLoss of saphenous nerve, branch of femoral.
Sjogren have what increased cancer riskNHL
Antiphospholipid found inAPL syndrome and SLE. Leads to hypercoagulable state and may lead to recurrent miscarriages. PTT is paradoxically increased despite propensity towards thrombosis.
What drugs reduce risk of bone fractureStatins, thiazides, beta blockers, and nitrates
Patients taking as little as 7.5 mg of prednisone for 6 months can develop osteoporotic bone changes. 30-50% of patients on long term systemic steroid use will have pathologic fractures in vertebral bodies. Mechanism?Decreased synthesis of bone matrix; inhibition of intestinal Vitamin D and increased PTH
MoraxellaNormal flora of upper respiratory tract; causes otititis media and sinusitis in healthy individuals and responsible for exacerbations of chronic obstructive pulmonary disease
Sporothrix histologyGranuloma of histiocytes, multinucleated giant cells, and neutrophils surrounded by plasma cell. Spreads along lymphatics.
Sporothrix wound isReddish nodule that will eventually ulcerate.
B19 in adults with pre-existing hemolytic diseaseAplastic crisis
Hand foot mouth disease what virusCoxsackie A; fever and ulcers on tongue/ oral mucosa and maculopapular on palms and soles
Red urineMcArdle disease from myoglobin with strenuous exercise
Ragged red fibersMitonchondrial diseases; muscle fibers with irregular contours and blotchy red appearance
Carnitine palmitoyltransferase deficiency**lipid myopathy with lipid accumulation in muscle fibers
Since T Tubules are extensions of sarcolemma they are extensions ofExtracellular space. Run perpendicular to long axis of muscle fibers and lie in close proximity to extensions of the sarcoplasmic reticulum/ terminal cisterns.
Question Answer
In skeletal muscle, 1 tubule to ? vs in cardiac muscle 1 tubule to1 T tubule contacts 2 terminal cisterns forming triad at A band and I band. Vs 1:1.
A lack of T tubuels in some myofibrils would lead toUncoordinated contraction of individual fibers
Postural muscles contain what type of fibersType I mostly; slow twitch; high oxidative phosphorylation and high myoglobin (oxygen storage) since they function mostly by oxidative phosphorylation
Impaired relaxation after a single contraction occurs inMyotonic dystrophy
Histology of ricketsIncrease in osteoid unmineralized and widened osteoid seams -> bowed legs, rachitic rosary, craniotabes, growth retardation, hypocalcemia and hypophosphatemia
Persistence of primary unmineralized spongiosa in medullary canalsOsteopetrosis
Hematogenous osteomy occurs predominantly in () and it affects () whereas adults usually due to () and affects ()Predominantly in young people and affects long bones and particularly at the metaphysis** due to slower blood flow and capillary fenestrae; adults usually due to IV drug abuse or indwelling vascular catheters and affects vertebrae. Staph aureus is implicated in most cases of acute hematogenous osteomyelitis in otherwise healthy children. Strep Pyogenes is #2 in children.
Osteomyelitis usually affects ()physisMetaphysis but may affect epiphysis if acute infection is not treated
Reactive bone is calledInvolucrum whereas retained necrotic bone is sequestrum
Hematogenous osteomy begins with seeding event that causesAcute cellulitis in bone marrow. That leads to inflammation, leading to increased intramedullary pressure, compromising blood flow forcing infectious exudate through vascular channels into the cortex and periosteal region. Disruption of periosteal blood supply further increases ischemia and causes necrosis. Can lead to chronic suppurative ostemy with necrotic bone as new reservoir for infection. Need AB and debridement of necrotic bone
Osteoprotegerin functionInhibits interaction of RANKL with RANK receptor. Secreted by osteoblast.
Bone turnover is regulated byRatio of osteoprotegerin and RANKL
Calcitonin released byParafollicular cells of thyroid. Inhibits osteoclast. Useful marker for medullary thyroid cancer and can treat hypercalcemia with it.
Bone make upInorganic (hydroxyapatite crystals) and organic (type 1 collagen). Gives flexibility to bone. Something like osteogenesis imperfecta where defective synthesis of collagen 1 leads to brittle bone
In osteogenesis imperfect, which is impaired, endochondrol or membranous oss?BOTH.
In addition to easy bruising and blue sclera, osteogenesis imperfect leads toExcessive laxity of joints; bruising and hearing loss; small malformed teeth. Can be mild form or lethal form. Usually ADominant*.
Low back pain and morning stiffness in a young manAnyklosing Spondylitis, chronic inflammatory condition; sacroiliac and apophyseal joints of spine are most affected; morning stiffness improves with activity; course of exacerbations and remissions; mild to moderate disease without permanent disability but maybe some limitations
Ankylosing spondylitis can affect what systemsEye (uveitis – pain, blurred vision, photophobia, conjuctival erythema); Cardio (aortitis -> dilation and insufficiency); Respiratory (costovertebral and costosternal junction involvement; pain can limit chest wall expansion leading to hypoventilation so chest expansion should be monitored; rarely pulmonary fibrosis); MSK (inflammation at site of tendon insertion into bone; calcaneus/ achilles tendon insertion, tibial tuberosity,. .. most commonly affected sites -> pain, tenderness, swelling)Severe acneIsotretinoin, topical tretinoin, benzoyl peroxide and antibiotics.