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Bone and CT
Bone and CT COMLEX 2
155
Medical
Graduate
05/09/2015

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Term
anti rbc
Definition
autoimmune hemolytic anemia
Term
anti epidermal BM
Definition
bullous phemogoid
Term
anti islet cell
Definition
DM1
Term
anti keratinocyte junction
Definition
phemphigus vulgaris
Term
anti intrinsic factor or parietal cell
Definition
pernicious anemia
Term
anti perinuclear antineutrophil cytoplasm
Definition
microcopic polyangiitis, polyarteritis nodisa
Term
anti neutrophil cytoplasm / anti peroteinase 3
Definition
wegners granulomatosis
Term
anti jo1
Definition
polymyositis, dermatomyosits
Term
anti-synthetase
Definition
polymyositis, dermatomyositis
Term
anti signal recognition particle
Definition
polymyositis, dermatomyositis
Term
anti- M1-2
Definition
polymyositis, dermatomyositis
Term
anti scl70
Definition
sclerodera
Term
anti tipoisomerase I
Definition
sclerodrema
Term
anti centromere
Definition
CREST
Term
antiSSa/Ro, anti SSb/Ra
Definition
sjogerns, subacute lupus, neonatal lupus, C3/C4 deficiency, ANA negative lupus, neonatal SLE (Ro/SSa only)
Term
anti structural platelet
Definition
idiopathic thrombocytopenic purpura
Term
anti melanocyte
Definition
vitiligo
Term
anti IgG
Definition
rheumatoid arthritis
Term
anti citrullinate peptide
Definition
RA, most specific
Term
anti leucine aminopeptidase
Definition
SLE, sjogerns
Term
anti ssDNA
Definition
SLE, sensitive
Term
anti dsDNA
Definition
SLE specific, lupus nephritis
Term
anti smoth
Definition
SLE specific
Term
anti cardiolipin / lupus anticoagulant
Definition
antihphospholipid antibody syndrome, SLE
Term
anti histone
Definition
drug induced lupus
Term
anti ACh recetpor
Definition
myasthenia gravis
Term
anti TSH receptor
Definition
graves
Term
anti microsomal ab
Definition
hashimotos
Term
anti gliaden
Definition
celiac sprue
Term
anti glomerular BM
Definition
goodpastures
Term
anti mitochondrial ab
Definition
primary biliary cirrhosis
Term
anti U1-RNA
Definition
mixed CT disease
Term
anti RNP
Definition
mixed CT disease
Term
HLA-AR3
Definition
hematochromatosis
Term
HLA-B27
Definition
ankylosing spondylitis, reactive arthritis, psoriatic arthritis, acute anterior uveitis
Term
HLA-DR2
Definition
SLE, DM2, sjogerns, graves
Term
HLA-DR4's
Definition
RA, JRA, DM1, polymyalgia rheumatica, lyme chronic arthritis
Term
HLA-DR5
Definition
JRA, kayoski sarcoma, hashimotos
Term
HLA-DR52A/CX7
Definition
primary sclerosing cholangiitis
Term
diseases using molecular mimicry
Definition
rheumatic fever, DM1, MS
Term
diseases using superantigen
Definition
RA
Term
SLE signs
Definition
butterfly rash, discoid rash, photosensitivity, arthralgia, pericarditis, pneumonitis, hemolytic anemia, leukopenia, thrombocytopenia, proteinuria, seizure, psychosis, neuropathy, libman-sacs endocarditis
Term
ANA negative lupus signs
Definition
anti-SSa/Ro or anti-La/SSb
neonatal lupus
subacute cutaneous lupus
Term
signs of neonatal lupus
Definition
skin lesions, AV block, transposition of the great vessels, valve defects, septal defects
Term
drugs causing lupus
Definition
sulfa, hydralazing, isoniazid, procanamide, phenytoion
Term
treatment lupus
Definition
local or systemic steroids
hydroxychloroquine
immune suppression
cyclophosphamide if GN
anticoagulation of thrombocytosis
Term
CREST
Definition
calcinosis of digits SC
raynauds
esophageal motility dysfunction (LES sclerosis)
sclerodactyly of fingers
talengesticas of digits under nails, lips, hands, face
Term
causes of livedo reticularis
Definition
anti-phospholipid antibody syndrome
polyarteritis nodosa
cholesterol emboli
Term
signs of RA
Definition
gel phenemon, boutinere, swan neck, valgus knees, ulnar deviated MCPs, symmetric, extensor nodules, pericarditis, subluxation of cervical spine, pleural effusions (low glucose), interstitial fibrosis, scleritis
panus, rice bodies, bursa, joint space narrowing
Term
feltys syndrome signs
Definition
RA, neutropenia, splenomeagly, anemia, thrombocytopenia
Term
treatment of RA
Definition
1) hydroxychlocoquine
2) sulfasalazine
2) methotrexate
4) TNFa inhibitor
Term
diagnosis of gout crystals
Definition
negative bifringence
in polarized light yellow when parallel, blue when perpendicular
needle shape
Term
diagnosis of pseudogout crystals
Definition
positive bifringence
in polarized light yellow when perpendicular, blue when parallel
rhomboid shaped
Term
signs of polymyositis
Definition
proximal muscle weakness, difficult to stand from chain or climb stairs
myocarditis, conduction deficits
ekevated CK, anti-jo1, LDH, aldolase,
Term
biopsy of polymyositis vs dermatomyositis
Definition
poly: endomysial lymphocytic inflammation between fibers, fibers very round

derm: perivascular and perimysial inflammation around vessels and fibers
Term
signs of dermatomyositis
Definition
polymyositis plus
helotrope rash, grottons papules, V sign, shawl sign, mechanics hands, telangesticas of the nailbed
Term
signs of inclusion body myositis
Definition
male, elderly, proximal and distal muscle weakness, CK only slight elevation, no auto-ab, biopsy shows endomysial fibrosis, cytoplasmic vacoules, basophilic granules, amyloid
Term
signs polymyalgia rheumatica
Definition
temporal arteritis
stiffness after inactivity, hip and shoulder pain, difficulty raising arms
low Hct, high ESR, no Rf, MRI with high signal intensity at tendon sheath, synovial tissue outside joints
Term
FDA approved drugs for fibromyalgia
Definition
pregabalin, duloxetine, milnacipran
Term
signs of ankylosing spondylitis
Definition
BL sacrolitis, LBP, enthesitis (inflammed tendon insertion), fractures, CP, uveitis, HLA-B27
Term
signs temporal arteritis
Definition
headache, temporal tenderness, scalp pain, amaurosis fugax, jaw claudication, polymyalgia rheumatica, multinucleated giant cells,
Term
signs takaysi arteritis
Definition
asian, female, fatigue, vertigo, syncope, limb ischemia, CVA, abnormal pulses, giant cells
Term
signs allergic granulomatosis with angiitis
Definition
asthma, allergic rhinitis, nasal polyps, sinusitis, SC nodules, p-ANCA, eosinophils
Term
signs polyarteritis nodosa
Definition
levido reticularis, mesenteric ischemia, gangrene of fingers, hypergammaglobinemia, renal parenchymal vessel aneurysms
Term
signs henoch scholein purpura
Definition
IgA nephropathy, migratory arthritis, palpable purpura of LE, GI bleeding, intussception
Term
signs kawasaki
Definition
high fever, conjunctivits, maculopapular rash on trunk, adenopathy, strawberry tongue, hand and foot desqumation, coronary aneurysms

IVIG and aspirin
Term
signs bechets
Definition
painful oral and geital ulcers, arthritis of knees and ankles, uveitis, optic neuritis, conjunctivitis
Term
signs buergers
Definition
male, smoker, ischemic claudication, cold, cyanosis, painful, paresthesia, ulceration, gangrene, superificial nodular phlebitis
Term
signs cervical myelopathy
Definition
(cervical stenosis)
gait disturbance, hand clumsiness, bladder and bowel dysfunction, weakness
Term
erb duchenes palsy
Definition
C5-6 hyperadduction
arm extended, adducted, pronated
Term
claw hand
Definition
ulner nerve
weak adduction, weak 4-5th digit flexion, lumbricle weakness claws 4-5th digits
Term
ape hand
Definition
median nerve damage, cannot pronate
Term
musculocutaneous nerve damage
Definition
loss of elbow flexion and supination
Term
wrist drop
Definition
radial nerve damage, loss of sensation to dorsal hand, loss of wrist and finger extension
Term
deltoid paralysis
Definition
anterior shoulder dislocation, cant abduct >10 deg, weak external rotation
Term
klumpkes palsy
Definition
C8-T1 injury
claw hand, horner syndrome, thenar and hypothenar atrophy
Term
treatment of clavicle fracture
Definition
neonate: none

adult: sling and PT for 4-8wk until pain gone, repeat x-ray in 6wk
Term
anterior dislocated shoulder cause, signs
Definition
trauma
external rotation, adduction, promonent acromion, deltoid numbness (axillary stretching)
Term
posterior dislocated shoulder, cause, signs
Definition
seizure, electricity
internally rotated, adduction, posterior prominence, anterior shoulder flat
Term
inferior dislocated shoulder signs
Definition
arm up by head or behind head
due to hyperabduction
Term
signs of subacromial bursitis
Definition
shoulder pain worse over head, awakens at night, positive neer imingement and hawkins
Term
treatment of olecranon fracture
Definition
open reduction and internal fixation, if not displaced posterior long arm splint at 30deg
Term
treatment of olecranon bursitis
Definition
conservative, only drain if infection suspected
Term
colles fracture: cause, distal radius, radial head, fracture, treatment
Definition
outstretched hand
posterior distal radius
no change in radial head
distal radius fracture
closed reduction
Term
smith fracture: cause, distal radius, radial head, fracture, treatment
Definition
flexed wrist fall
anterior distal radius
no change in radial head
fractured distal radius
closed reduction
Term
monteggia fracture: cause, distal radius, radial head, fracture, treatment
Definition
fall on outstretched hand in pronation, ulnar blod
no change in distal radius
anterior radial head
ulnar fracture
open reduction
Term
gleassi fracture: cause, distal radius, radial head, fracture, treatment
Definition
distal radial blow
posterior distal radius
no change in radial head
distal radial head fracture
open reduction
Term
nursemaids elbow cause, tx
Definition
subluxation of radial head, held flexed and pronated during injury

supination and 60deg flexion or hyperpronation
Term
treatmetn of scaphoid fracture
Definition
negative x-ray but snuff box tenderness spica cast 7-10d and re x-ray

positive x-ray cast for 6wk
Term
boxer fracture cause, tx
Definition
closed fist hits surface breaking 5th metacarpal neck

closed reduction and ulnar gutter splint
Term
signs of trigger finger
Definition
wake up at night with flexed A1 pully, can only manually extend, associated with DM and females
Term
cause of deQuarvain denosynovitis
Definition
abductor pollicus longus tentonsynovitis
Term
gamekeeper thumb cause, sx, tx
Definition
injury of ulnar collateral ligament due to hyperextension causing 1st MCP laxity

tx casting
Term
jersey finger cause
Definition
injury to flexor tendon when flexed finger is forced into extension
Term
mallet finger cause
Definition
injury to extensor tendon when extended finger is forced into flexion
Term
rolando fracture
Definition
3 part communuted fracture at base of 1st metacrapal
Term
bennet fracture
Definition
fracture of 1st metacarpal extending into carpometacarpal joint
Term
causes of hip dislocation
Definition
internal rotation, flexion, adduction posterior force (dashboard)
Term
signs of hip fracture
Definition
laying with leg shortened, externally rotated
Term
trochanteric bursitis signs
Definition
lateral hip pain, pain on palpation
Term
#1 knee injury
Definition
medial collateral ligament
Term
knee injury caused by dashbord
Definition
posterior cruciate
Term
osteochondritis dissecans cause, signs
Definition
necrotic bone and degenerative cartilage separate and float around in joint space
cause pain catching, popping, crepitus, effusion, tenderness
usually in physically active adolescents
Term
pes anserinae bursa cause, sx, tx
Definition
bursa at anteromedial tibia (gracilis, satorus, semitendinosus insertion), pain with lateral knee movement

hamstring flexability, PT, steroid injection if severe
Term
bakers cyst signs and dx
Definition
swelling of semimembranosus popliteal bursa
cystic mobile, tender mass
mimics thrombobphebitis when extends down
DX WITH US
Term
diagnosis of patellar fracture
Definition
lateral x-ray
Term
plica syndrome cause
Definition
diagnosis of exclusion, flap of tissue on back of patella causes snap feeling when walking
Term
most common cause and type of compartment syndrome
Definition
tibia or fibula fracture
anerior
Term
signs of achilles rupture sx, tx
Definition
out of shape middle aged man thinks he is going to rock some strange activity this weekend, he doesn't
loud pop as he changes direction, limited plantar flexion, tendon gap, position thompson, pain in superior heel

cast in equinus for several months
Term
grading ankle sprains
Definition
1) partial ATF
2) complete ATF, partial CFL
3) complete ATF and CFL
Term
cause of tarsal tunnel syndrome
Definition
posterior tibial nerve posterior to medial malleolus
Term
cause of morton neuroma
Definition
intermetatarsal plantar nerve (common digitial) 2-3rd
Term
when do you MRI back pain
Definition
neurological deficits (beyond the knee), prolonged steroid use, osteoperosis, unexplained fever or weight loss, risk of malignancy, recent trauma, history IV drug use
Term
what position is prefered in herinated disc, spinal stenosis, and spondylolisthesis
Definition
herniated: extension
stenosis: flexion
spond: flexion
Term
when do you do surgery on a disc
Definition
symptoms >1y, progressive neurological symptoms, cauda equina
Term
cause spondylitis
Definition
inflammation of vertebrae (ankylosing)
Term
cause spondylosis
Definition
degenerative change in vertebrae at zygopop joints narrowing disc space
Term
cause of spondylolisthesis signs
Definition
anterior displacement of vertebrae

walk with waddle knees and hips flexed, palpable slip off, often gymnast, football, weight lifter
Term
cause of lytic and blastic bone lesions
Definition
lytic: multiple myeloma, breast cancer, lung cancer

blastic: prostate cancer
Term
compartment syndrome associated with shin splints and tibial stress syndrome
Definition
superificial
Term
complication of posterior knee dislocation
Definition
popliteal artery compormise
Term
signs of developmental hip displasia
Definition
uneven gluteal folds
hip dislocation with click on return
delayed walking
glazelli: knees unequal when hips flexed
trandelenburg gait: sag in opposite hip
bartlow and ortolandi: abductiona nd elevation dislocates it
Term
treatment of developmental hip displasia
Definition
<6mo pavlik harness 6mo
6mo-2y closed or open reduction, spica cast
>2y open reduction
>8y reduction has reduced benifit
Term
lagg clave perthesis signs
Definition
avascular necrosis of femoral epiphysis
6yo, limp, knee or hip pain, femoral head sclerotic
Term
slipped capital femoral epiphysis cause, sx, tx
Definition
separation through growth plate of femoral epiphysis from metaphysis
adolescent, obese, groin or knee pain, sole of foot pointed inward when dangling, limited RPM, externally rotated thigh in hip flexion

x-ray with posterior, inferior, edial displacement of head, ice cream falling off cone

emergent pinning, weight restriction
Term
signs of kid with septic hip
Definition
toddle, febrile, refuses to move hip, holds leg in flexion, abduction, external rotation
Term
acute hematogenous osteomyelitis signs
Definition
febrile, localized pain, no trauma, normal x-ray, MRI is diagnostic, tx abx
Term
signs of rickets
Definition
bone pain, bowed legs, kyphoscoliosis, proximal limb weakness, soft skull bones, fractures, bone soft, increased ALKP and PTH, decreased Ca and P, wide physes, bowed long bones, translucent lines in bones, pseudo fractures (milk man lines), enlarged costal cartilages (rickets risery), flattening of skull
Term
when is genu valgus and varum normal
Definition
valgus: 4-8yo
varum: <3yo
Term
signs osgood schlatter
Definition
inflammed cartilage at tibial tubercle, young boy, athletic, pain on tubercle, aggervated by quad contraction, swelling, tender, warm
Term
signs of club foot
Definition
plantar flexion, inversion, adduction
Term
types of growth plate fractures
Definition
1) physeal separation, no bone fracture - good prognosis

2) partial physeal separation, some metaphysis fracture - good prognosis

3) partial physeal separation, some epiphysis fracture - poor prognosis

4) fracture through metaphysis, physis, epiphysis - poor prognosis

5) crush - likley growth arrest
Term
pauciarticular arthritis signs
Definition
non-migratory
<5yo
<5 large joints (not hip)
uveiitis
Term
signs polyarticular arthritis
Definition
2-5 or 10-14yo
>5joints (helps not common)
hand deformities (dictylitis)
spine involved
symmetric
Term
stills disease signs
Definition
any number of joints, acute significant pain, no particular arthritis
maculopapular salmon colored rash, fever, sore throat, stiff neck, pericarditis, lymphadenopathy, jaw involvement
Term
#1 primary malignant bone tumor, signs
Definition
osteosarcoma

deep bone pain, femur, tibia, humerus, palpable, swelling, high ALK-P, sunburst, codmans
Term
#1 primary malignant bone tumor, sugns
Definition
ewing sarcoma

5-15yo, male, bone pain, swelling, fever, fatigue, fracture, mass, low Hbg, codemans, onion skin
Term
#1 primary benign bone tumor, signs
Definition
osteochondroma

growth off metaphysis, irritated soft tissue, femur or tibia, non-tender, hard, cancellous portion continous with interior of lesion
Term
two types of osteoperosis and their associations
Definition
1) loss of trabecular bone: vertebral compression fx, colles fx, post-menopause

2) loss of cortical and trabecular bone: femoral neck, proximal humerus, and pelvic fx, men and women >70yo
Term
indications for osetoperosis medication
Definition
T<-2.5
T-1 to -2.5 with 10y fx probability >3%
Term
treatment of osteoperosis
Definition
bisphosphonates
teriparatide: PTH
SERM: raloxetine
micalcin: calcitonin
denosumab: RANKL inhibitor
Term
osteropertosis cause, signs
Definition
increased osteoclast activity increases bone density, blindness, deafness, fracture, compression of nerves, erlenmeyer flask deformity, thick skull bones
Term
signs of osteoarthritis
Definition
asymmetric, crepitus, worse in morning, worse with activity, decreased RPM, heberden nodules at DIP, boucarde nodules at PIP, subchondral cysts, sublexation, sclerosis, osteophytes
Term
signs of pagets
Definition
overactive osteoclasts and osteoblasts, excessive turn over, disorganized mosaic lamellar bone pattern

deep pain, fractures, tibial bowing, kyphosis, increased cranial diameter, deafness, headache, nerve entrapment, high ALK-P and urine hydroxyproline, osteolytic lesions, hyperdense bone
Term
treatment of pagets
Definition
bisphosphonates, calcitonin SQ, NSAIDs
Term
signs of OI
Definition
fractures, blue sclerae, skin and teeth deformities, deafness, joint hypermobility, fractures in utero, pliable skin
Term
treatment of septic joint
Definition
adult, healthy, likley S. aureus: b-lactam pen + 1st gen ceph + vanco

probablly gonorrhea: 3rd gen ceph IV

compormised: 3rd gen ceph or aminoglycoside + pseudomonas pen
Term
causes of osteomyelitis
Definition
S. aureus most common
neonate: GBS
kids: S. aureus then E. coli
IV drugs, neutropenia: pseudomonas, fungi
nosocomal: pseudomonas
diabeic foot: polymicrobial
prosthetic: coag negative staph
potts: TB
sickle cell: salmonella
Term
causes of septic joint
Definition
most common: S. aureus
sexually active: gonorrhoeae
cat/dog bite: pasturella
Kids: S. aureus, H. flu
sickle cell: salmonella
compormised: GNR
prosthetic: S. epidermitidis
Term
how is osteomyelitis monitored
Definition
ESR and CRP
Term
signs if stage 3 lyme
Definition
arthritis in large joint: knee, shoulder, elbow, ankle
subacute encephalitis
acrodermatitis chronica atrophicans: red purple plaques and nodules on extensors of legs
Term
treatment of lyme
Definition
early doxy
late ceftriaxone
Term
signs of RMSF tx
Definition
rash starting on palms and soles going in, macular then papular then petechial, HSM, thrombocytopenia, DIC,

doxy
Term
cause RMSF
Definition
dermacentor varibilis rick
ricketsia rickettsi intracellular
Term
transient synovitis cause, sx
Definition
painful limp post URI 4-8yo, aferile, normal ESR/WBC, limited ROM

tx NSAIDS
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