Term
| What are the 3 subcategories of an acute joint problem |
|
Definition
| Infection, Crystal Induced, Trauma |
|
|
Term
| Key to differentiating Articular vs. Non-Articular in Diagnosis. |
|
Definition
| ROM normal with passive action |
|
|
Term
| What 3 Diagnostic methods are used to test for acute joint infection? Which is usually first? |
|
Definition
| Synovial Fluid Tests (first), Blood test, X-ray |
|
|
Term
| What 4 attributes are found from a Synovial Fluid Test of a joint? |
|
Definition
| Cell count, Gram Stain, Culture, Crystal ID |
|
|
Term
| With what pathology is Fibrillin 1 protein associated? |
|
Definition
|
|
Term
| What protein has multiple roles in the body, but a defect in it often leads to weakness in the aorta, lenses, bones, and lungs? What subsequent signaling factor is affected by the aforementioned protein defect? |
|
Definition
|
|
Term
|
Definition
A- elastic
B- Fibrocartilage
C- Hyaline Cartilage
D- Bone |
|
|
Term
When of the following are cells, protein fibers, and ground substance?
-Mesenchymal
-Glycosaminoglycans
-Elastin
-Collagen
-Proteoglycans
-Reticular
-Macrophage
-Adipocyte
-Water
-Fibroblast |
|
Definition
-Mesenchymal: Cell
-Glycosaminoglycans: Ground Substance
-Elastin: Protein Fibers
-Collagen: Protein Fibers
-Proteoglycans: Ground Substance
-Reticular: Protein Fibers
-Macrophage: Cell
-Adipocyte: Cell
-Water: Ground Substance
-Fibroblast: Cell |
|
|
Term
| What is the origin of connective tissue? What is the exception? |
|
Definition
| Mesenchymal cells; Hemopoetic cells |
|
|
Term
| To what do myeloid stem cells give rise?With What exception? Where does it all occur in the body? |
|
Definition
| Hemopoetic cells; Lymphocytes (Monocytes); Bone Marrow |
|
|
Term
ID the following by which type of Dense Connective Tissue:
-Tendons and Ligaments
-Epidermis to skin
-External Ear
-Parallel Arrays of collagen
-Perichondrium
-Reduced blood supply
-Higher amount of ground substance |
|
Definition
-Tendons and Ligaments: Regular
-Epidermis to skin: Irregular
-External Ear: Elastic
-Parallel Arrays of collagen: Regular
-Perichondrium: Irregular
-Reduced blood supply: Regular
-Higher amount of ground substance: Irregular |
|
|
Term
ID based on Loose Connective Tissue Type:
-Surround and protect organs
-Store energy
-Supportive framework (spleen, lymph nodes, thymus, bone marrow) |
|
Definition
-Surround and protect organs: Areolar
-Store energy: Adipose
-Supportive framework (spleen, lymph nodes, thymus, bone marrow): Reticular |
|
|
Term
| What is avascular, not protected by the immune system, and involved in several disorders (Chodrodystrophy, Arthritis, Achondroplasia, and Chondroma)? |
|
Definition
|
|
Term
| "Chondromalacia" is the onset of what? |
|
Definition
|
|
Term
ID by type of cartilage supportive connective tissue:
-Glassy look/ slicker than ice
-"Yellow Cartilage"
-Replaces damaged hyaline cartilage
-Strongest- made from Type 1 collagen
-Mostly type II collagen
-Oriented in all directions |
|
Definition
-Glassy look/ slicker than ice: Hyaline
-"Yellow Cartilage": Elastic
-Replaces damaged hyaline cartilage: Fibrocartilage
-Strongest- made from Type 1 collagen: Fibrocartilage
-Mostly type II collagen: Hyaline
-Oriented in all directions: Elastic |
|
|
Term
| What are the two types of bone connective tissue? |
|
Definition
|
|
Term
| What would occur that would erroneously allow HLA-DR4 to instigate an autoimmune response? If DR4 is allowed to bind, what does it alter? |
|
Definition
| Citrullination- POST-TRANSLATIONAL modification of arginine; negative selection of T-cells in the Thymus |
|
|
Term
| An increase in RF and ACPA indicates what? |
|
Definition
| Autoimmune response to Citrulline |
|
|
Term
| For what does ACPA stand? Which Ig does it measure? What else is indicative of this particular Ig? |
|
Definition
| Anti-Citrulinated Peptide Antibody; IgG; RF |
|
|
Term
| An auto-reactive T-cell will release what two primary cytokines during autoimmunity? |
|
Definition
|
|
Term
| To what can smoking, E. Coli, and urban living lend more susceptibility? Is it more common in females or males? |
|
Definition
|
|
Term
| Does the innate immune mechanism occur inside or outside the joint space is autoimmune pathology. Can angiogenesis occur? |
|
Definition
|
|
Term
What do the following CD4+ T-cell derivatives do?
-TFH
-TH1
-TH2
-TH17
-TReg
Which two are the most prominent? |
|
Definition
-TFH: help B cells
-TH1: help CD8+ T-cells (Killers)
-TH2: help IgE B cells
-TH17: induce inflamation
-TReg: regulate other lymphocytes
Th1 and Th17 |
|
|
Term
| What three cytokines stimulate Th17? Which is most important? |
|
Definition
| Il-1, Il-6, and TGF-alpha; IL-1 is key |
|
|
Term
| What cytokine causes inflammation, induces fibroblast proliferation, activates chondrocytes to breakdown cartilage, and activates osteoclasts via Th17? |
|
Definition
|
|
Term
| What two cytokines stimulate Th1 to help CD8+ T-cells? |
|
Definition
|
|
Term
| What T-cell type suppresses inflammation? What cytokines promote inflammation? |
|
Definition
| TReg; TNF-alpha, IL-17, and IL-22 |
|
|
Term
| Drug Therapies for autoimmune disease involve what 3 main target types? Which is often used? |
|
Definition
| Deplete cells (Macrophages, B and T cells); Block cellular interactions; Most used- Inhibit cytokine effector mechanisms (specifically TNF-alpha and IL-1) |
|
|
Term
| HLA-B27 class I molecule is indicative of what pathology? |
|
Definition
|
|
Term
| If Gout is suspected, what acid should be high in the blood test? Above what level? |
|
Definition
|
|
Term
| What joint is often involved in Gout? What time is often the onset? |
|
Definition
| Metatarsophalangeal Joint; Night-time |
|
|
Term
Is this characteristic of RA or OA?-
Pain after use, improvement with rest, unilateral |
|
Definition
|
|
Term
Is this characteristic of RA or OA?-
Greater than an hour of morning stiffness in joint, improvement with use; bilateral |
|
Definition
|
|
Term
| What are the names of nodes at the proximal and distal IP joints in OA respectively? |
|
Definition
| Bouchard and Herberden Nodes |
|
|
Term
Put these Risk Factors for OA in order:
Obesity, Female, Trauma, Genetics, Age, Occupation |
|
Definition
| Age, Obesity, Occupation, Female, Trauma, Genetics |
|
|
Term
| What is the source of primary OA? Secondary? |
|
Definition
| Unknown- general wear and tear; trauma or another disorder |
|
|
Term
| What are the 6 criteria for OA in the knee? How many need to be present to diagnose? |
|
Definition
| Older than 50, 30 min+ stiffness, Crepitus, Bony tenderness, Bony enlargement, No palpable warmth; 3 criteria |
|
|
Term
| 90% of casework for Joint Disorders will be what 2 pathologies? |
|
Definition
|
|
Term
| What is eroded in OA (DJD)? |
|
Definition
|
|
Term
| What are the 4 stages of Degradation in OA (DJD)? |
|
Definition
| Fibrillation; Bone Cysts; Eburnation; Osteophytes |
|
|
Term
| Which vertebral regions are most susceptible to "lipping" |
|
Definition
|
|
Term
| Which is a systemic inflammation that can affect other organs as well- OA or RA? |
|
Definition
|
|
Term
| What are the 3 stages of RA? |
|
Definition
| Synovitis; Pannus; Ankylosis |
|
|
Term
| What is Synovitis? What test can indicate this stage? Is it an asolute confirmation? |
|
Definition
| Inflammation of synovial membrane; RF test (IgG); No- may be normal or related to another issue |
|
|
Term
| What is the Peri-nuclear Hof? Is it viewed for RA or OA? |
|
Definition
|
|
Term
| What stage of RA involves Synovial Fronds transforming into granulose tissue, creating a "cloth cover". |
|
Definition
|
|
Term
| What does Ankylosis do to the joint? |
|
Definition
|
|
Term
| What occurs with a Rheumatoid Nodule? |
|
Definition
| Central Necrosis surrounded by macrophages and lymphocytes |
|
|
Term
| If Giant Cells are present what two benign tumors could be present in the synovial lining? |
|
Definition
| Pigmented Villonodular Synovitis or Noduular Tenosynovitis |
|
|
Term
|
Definition
|
|
Term
| What are the 3 main therapies for RA?Which is most prevalent? Why not the other two? |
|
Definition
| Corticosteroids, DMARDs, NSAIDs; DMARDs; Corticosteroids have many side effects and NSAIDs are not disease modifying |
|
|
Term
| What causes Cushing's Disease? |
|
Definition
| Excessive or high doses of corticosteroids |
|
|
Term
| Drugs that end in "ab" =, "cept", or "nib" are collectively what type? What are for specifically? |
|
Definition
| Biological DMARDs; monoclonal antibodies (bind antigen or receptor), Fusion Proteins, and Kinase Inhibition |
|
|
Term
| What type of DMARD is Murine? How does this DMARD prevent inflammation? |
|
Definition
| Monoclonal Antibody- derived from a Xenomouse; binding to antigen or receptor |
|
|
Term
| What does Entanercept and Abatacept do? What type of DMARD are they? |
|
Definition
| Provides a false receptor for TNF-alpha (anti-inflammatory); Fusion Protein |
|
|
Term
| What does Tofacitinib do? What type of DMARD is it? |
|
Definition
| Affects enzyme receptors to affect second messaging; Kinase Inhibition |
|
|
Term
| Black Box Warning for DMARDs = increased risk for...? |
|
Definition
|
|
Term
| What is the purpose of MTX (Methotrexate)? What type of DMARD is it? |
|
Definition
| Inhibit DNA and RNA synthesis; Conventional DMARD |
|
|
Term
| What is the major issue with MTX? Why is Leflunomide better? |
|
Definition
| 6-8 hr 1/2-life; 2 week half-life |
|
|
Term
For arthritis- which drug is better?-
Daptomycin, Linezolid, Ceftaroline, Clindamycin. When would you want to use one of the other ones? |
|
Definition
| Ceftaroline; beta-lactam allergy |
|
|
Term
| What Arthritic drug is only good for Gr+ and cannot be given with statins? |
|
Definition
|
|
Term
| What arthritic drug is only good for Gr+, inhibits protein metabolism at the 50S unit, and cannot be given with serotonin increasers (ie- Prozac)? |
|
Definition
|
|
Term
| What are the 6 Cephalosporins to know? |
|
Definition
| Cefazollin, Ceftriaxone, Ceftazidime and Cefepime, Cefoxitin, Ceftaroline |
|
|
Term
| What arthritis medication inhibits protein metabolism at the 50S Ribosomal Unit and is good for necrotizing faciitis? If related to MRSA, then what? |
|
Definition
|
|
Term
| Which Cephalosporin is best for: MRSA? MSSA? |
|
Definition
|
|
Term
| Which Cephalosporin is best for: Anaerobic Bacteria |
|
Definition
|
|
Term
| Which 2 Cephalosporin are best for: P. aeruginosa |
|
Definition
|
|
Term
| Which Cephalosporin is best for: Lyme Disease, Meningitis, and Gonorrhea? |
|
Definition
|
|
Term
| Which humeral neck frequents more fractures in adults? Which is proximal relative to the other? |
|
Definition
|
|
Term
| What nerve is at risk of damage if a humeral fracture is at: a) surgical neck, b) distal humerus, c) medial epicondyle, d) Radial Groove |
|
Definition
Surgical neck- Axillary n.
Distal Humerus- Median n.
Medial Epicondyle- Ulnar n.
Radial Groove- Radial n. |
|
|
Term
| What are the 4 Rotator Cuff muscles? Which is medial to the others? What is the order from the anterior position for the lateral muscles? |
|
Definition
| Subscapularis, Supraspinatus, Infraspinatus, Teres minor |
|
|
Term
| What are the three attached muscles below the bicepital groove on the humerus, starting most medially? |
|
Definition
| Teres Major, Latissimus Dorsi, Pectoralis Major |
|
|
Term
| What are the 3 anterior arm muscles and innervation? The one posterior arm muscle and innervation? |
|
Definition
Biceps Brachii, Brachialis, Coracobrachialis, Musculotaneous n.
Triceps Brachii, Radial n. |
|
|
Term
| In the antecubital fossa, what 3 veins, 2 nerves, artery and tendon run through it. |
|
Definition
| Cephalic, Basilic, Median Cubital (connects previous two), Radial n., Median n., Brachial a., Biceps tendon |
|
|
Term
| Which arm vein empties into the Axillary vein? Brachial Vein? |
|
Definition
|
|
Term
| What 3 Joints make up the Shoulder Complex? What 4th assists joint? |
|
Definition
Sternoclavicular
Acromioclavicular
Glenohumeral
(Scapulpthoracic) |
|
|
Term
| What does the Sternoclavicular Joint have between it? |
|
Definition
| Fibrocartilage Disc between two synovial cavities |
|
|
Term
| What are the two portions that make up the Coracoclavicular Ligament? Which is medial? This ligament is a part of what joint? What is the other ligament involved in this joint? |
|
Definition
| Conoid and Trapezoid; Conoid; Acromioclavicular Joint; Acromioclavicular Ligament |
|
|
Term
| What are the 3 ligaments of the Glenohumeral Joint? Which is most important? |
|
Definition
| Superior, Middle, and Inferior Glenohumeral Ligaments; Inferior Ligament (nothing else there) |
|
|
Term
| In what direction will the humerus go if dislocated? What do you want to check before setting? |
|
Definition
|
|
Term
| What is "Nursemaid's Elbow"? |
|
Definition
| Child dislocates Radius from Proximal Radio-ulnar Joint (Anular Ligament) |
|
|
Term
| What are the 3 ligaments of the elbow? |
|
Definition
| Ulnar collateral, Radial collateral, and the Anul(l)ar Ligament |
|
|
Term
| In addition to the two joints in the wrist due to the forearm bones, where is the 3rd wrist joint? |
|
Definition
|
|
Term
| Which carpals are on the distal end of the midcarpal joint? |
|
Definition
| Trapezium, Trapezoid, Capitate, and Hamate |
|
|
Term
| Which Carpal bone is most often injured? Second? |
|
Definition
|
|
Term
| What hypothesis postulates "for every enzyme there is a gene"? What is the key to discovering which genes control which enzymes? |
|
Definition
| One Gene-One Enzyme Hypothesis; Mutations |
|
|
Term
| What would be seen in lab if a trait truly followed one-gene, one-enzyme inheritance? |
|
Definition
|
|
Term
| What is the term for when one allele masks the presence of another? |
|
Definition
|
|
Term
| What type of collagen defect is associated with Osteogenesis Imperfecta? Osteoarthritis? Ehlers-Danlos Syndrome? |
|
Definition
| Type I, Type II, Type III and V |
|
|
Term
| What are the 3 main components of Collagen? |
|
Definition
| Polymers (Protofilaments), Elastin, and Fibrillin |
|
|
Term
| How many genes control Elastin? How many variants? |
|
Definition
|
|
Term
| What Collagen component regulates TGF-beta signaling? In what disease is an irregularity in this collagen component implicated? |
|
Definition
| Fibrillin; Marfan's Syndrome |
|
|
Term
| What aspect of a Proteoglycan Protein draws water to make a gelatinous substance in collagen? |
|
Definition
| The negative charge derived from repeated disaccharide units on the GAG (Glycosaminoglycan), attached to the Glycoprotein to form Proteoglycan draws water. |
|
|
Term
| Of the 4 major collagen mutations- Marfan's, Ehlers-Danlos, Osteogenesis Imperfecta, and Achondroplasia- which are Autosomal Dominant and which is often due to spontaneous mutation? |
|
Definition
AD- Marfan's, Ehlers-Danlos, OI
Spontaneous- Achondroplasia |
|
|
Term
| A genetic mutation of the FBN1 gene leads to what syndrome? |
|
Definition
|
|
Term
| Classic Ehlers-Danlos Syndrome is associated with a defect in which collagen type? Vascular? |
|
Definition
|
|
Term
| A mutation in the FGFR3 gene leads what type of collagen syndrome? |
|
Definition
|
|
Term
| Why is "Junk DNA" useful for DNA mapping of mutations? What is the name for segments conserved and passed down without meiotic recombination? What is the term for different sequences between people at the same genetic location? |
|
Definition
| Serves as markers to possession of mutation if linked; Haplotypes' Polymorphisms |
|
|
Term
| What molecular technique amplifies DNA? How would you demonstrate linkage? |
|
Definition
|
|
Term
| What molecular technique can track translocation of DNA across different chromosomes? What technique can compare multiple factors between different DNA segments at once(ie- normal vs disease, stem vs differentiated, muscle vs neuron, ect...)? |
|
Definition
| Southern Blotting; Microarray |
|
|
Term
| What is the main bacteria that causes septic arthritis in native joints and early on in prosthetic joints? |
|
Definition
|
|
Term
| Which class of NJI (Native Joint Infections) has the higher mortality? Which is typically polyarticular in presentation? |
|
Definition
| Nongonococcal; Gonococcal |
|
|
Term
| What 3 aspects of a synovial fluid draw is indicative of an infection? |
|
Definition
| WBC count, Gram stain, culture |
|
|
Term
| Name that bug: Catalase +, Coagulase +. What kind of hemolysis is expected? What generation of cephalosporin would you use? |
|
Definition
| S. aureus; beta hemolysis; 1st generation |
|
|
Term
| Name that bug: Releases Protein A, Coagulase, Hemolysins, Leukocidins, Penicillinase (beta-lactamase). |
|
Definition
|
|
Term
| Name that bug: Releases Hyaluronidase, Staphlokinase, Lipase, Protease. |
|
Definition
|
|
Term
| Name that bug: Catalase + and Coagulase -. Type of hemolysis? Treat with what generation of Cephalosporin? |
|
Definition
| S. epidermidis; gamma (none) hemolysis; 1stgeneration |
|
|
Term
| Which 3 bugs have polysaccharide capsules? |
|
Definition
| S. aureus, S. epidermidis, K. kingae |
|
|
Term
| Which two bugs produce biofilms? |
|
Definition
| S. epidermidis, B. burgorferi |
|
|
Term
| Which two bugs do not have capsules, but present antigenic variation? Which bug has a capsule of 13 varieties? |
|
Definition
| N gonorrhoeae, B burgorferi; N. meningitidis |
|
|
Term
| What are the two cocci Gr- bugs? Which only oxidizes glucose? |
|
Definition
| N gonorrhoeae, N. meningitides; N. gonorrhoeae |
|
|
Term
| Do the Neisseria bugs hemolyse blood? What kind of agar is typically used? |
|
Definition
| No (Gamma); Chocolate (Sheep blood lysed by heat) |
|
|
Term
| Which Neisseria release IgA protease? Which has "Opa" proteins for epithelial cells? |
|
Definition
|
|
Term
| What generation of cephalosporin is bets for Neisseria? |
|
Definition
|
|
Term
| Name that bug: Gr- and beta hemolytic?What type of cephalosporin is best? |
|
Definition
| K. kingae; 3rd generation |
|
|
Term
| What demographic is often affected by Kingella kingae? |
|
Definition
|
|
Term
| Endocarditis can result from which two bugs? |
|
Definition
|
|
Term
| Name that bug: spirochete, obligate intracellular, flagella, biofilms? |
|
Definition
|
|
Term
| What are the 3 stages of Lyme disease? |
|
Definition
| Local bulls-eye rash; multiple bulls-eye with neural, heart, lung, manifestations; chronic arthritis |
|
|
Term
| Name that bug: Bacilli, gamma hemolysis, bleach odor, human bite/fist injury, may cause endocarditis. What type of cephalosporin would be used? |
|
Definition
| E. corrodens; 3rd generation |
|
|
Term
| What does the ELISA test detect? What detects just antibodies? |
|
Definition
| Microbial antigens or host antibodies; Western blot |
|
|
Term
| What is the word for the lowest concentration in testing that produces a positive reaction? |
|
Definition
|
|
Term
| What is the time mark between acute and chronic OA? |
|
Definition
|
|
Term
| If a patient displays symptoms of arthritis without an elevated RF factor, what 4 pathologies are likely? What are they collectively called? What in the serum is present for all four of these pathologies? |
|
Definition
| Ankylosing Spondylitis, Reiter Syndrome, Psoriatic Arthritis, Enteropathic Arthritis (IBD); Seronegative Spondyloarthropathies; HLA-B27 |
|
|
Term
| Name a Cephalosporin generation drug: 5, 1, 3, 2, 3, 4 |
|
Definition
| Ceftaroline, Cefazolin, Ceftriaxone, Cefoxitin, Ceftazidime, Cefepime |
|
|
Term
| A person presents with knee pain, no elevated RF, and lesions on the hands, feet, penis with reduced vision. |
|
Definition
|
|
Term
| A person presents with Lower back pain, hunched over, no elevated RF, and is 20 years old. |
|
Definition
|
|
Term
| A person presents with knee pain, no elevated RF, and has psoriasis. |
|
Definition
|
|
Term
| A 29 yr old person presents with knee pain, no elevated RF, and presents with diarrhea, cramps, and pain. |
|
Definition
|
|
Term
| What are the 3 types of chronic, inflammatory arthrtisis? |
|
Definition
| Systemic (ie- Rheumatoid), Seronegative, and Inflammatory |
|
|
Term
| What are the 2 serologic markers for RA? |
|
Definition
|
|
Term
| Is RA noserologic, systemic or inflammatory under chronic arthritis? |
|
Definition
| Systemic (there is an inflammatory OA) |
|
|
Term
| What would you expect the Serologic markers for RA to be with Inflammatory OA? Inflammation markers? |
|
Definition
|
|
Term
| What two bones make up the Subtalar Joint? True Ankle Joint? |
|
Definition
| Talus and Calcaneous; Tibia, Fibula, and Talus |
|
|
Term
| What is the most common ankle sprain? Which Ligaments? |
|
Definition
| Inversion; Lateral Ligaments |
|
|
Term
| What is a Syndesmotic sprain? |
|
Definition
| Higher ankle (Talus & Tibia) |
|
|
Term
| What type of sprain involves the deltoid ligament? Is it common? |
|
Definition
|
|
Term
| What Ligaments are involved in a Type I Inversion sprain? Type II? Type III? Which is most common? |
|
Definition
| Anterior Talofibular Lig.; Ant. Tib Fib & Calcaneofibular Lig.; Ant. Tib Fib & Calc Fib & Posterior Talofibular Lig.; Type I |
|
|
Term
| What effect does an inversion ankle sprain have on the: Calcaneous? Fibular Head? Femur? |
|
Definition
| Eversion; Posterior movemement; Internal Rotation |
|
|
Term
| What is meant by 1st, 2nd, and 3rd degree for sprains? Which perhaps may need surgery? |
|
Definition
| intact, partial tear, complete rupture; 3rd degree |
|
|
Term
| In order to get an xray of the ankle or foot, you need 1) Patient unable to bear weight after injury and 4 steps in office, and 2) (for each)? |
|
Definition
| Ankle- tenderness on malleolus tip; Foot- tenderness at base of 5th metatarsal or navicular |
|
|
Term
| What is the treatment for a sprain? |
|
Definition
| RICE- Rest, Ice, Compression, Elevation |
|
|
Term
| A patient with foot pain that is obese, flat footed, used to run marathons likely has what? What would you recommend? |
|
Definition
| Plantar Fasciitis; Rest, NSAIDs, calf exercises, shoe inserts |
|
|
Term
| What three muscle tendons make up the anatomical "snuff box"? |
|
Definition
| Extensor pollicus longus, Extensor pollicus brevis, abductor pollicis longus |
|
|
Term
| What does it mean to flex the thumb? Adduct? Oppose? |
|
Definition
| Thumb to 5th digit; making an "L"; little finger to thumb |
|
|
Term
| 3 muscles of the Hypothenar eminence? 3 muscles of the Thenar eminence? |
|
Definition
| abductor digiti minimi, flexor digiti minimi, opponensdigiti minimi; abductor pollicis brevis, flexor pollicis brevis, oppenens pollicis |
|
|
Term
| What innervates the Hypothenar muscles? Thenar Muscles? Adductor pollicis? |
|
Definition
|
|
Term
| Which interosseoi muscles adduct? Abduct? What innverates each? |
|
Definition
| Palmar; Dorsal; Ulnar n. for both |
|
|
Term
| What innervates the Lumbricals? Where do they insert? What does that doe to the fingers? |
|
Definition
| Ulnar n. except lateral 2 which are median n.; extensor hood; L-shaped (flex MCP but extend IP) |
|
|
Term
| What cutaneous innervation is the medial 1 1/2 digits? Most of the palm and tips of fingers? Dorsal-lateral hand? |
|
Definition
| Ulnar n.; Median n.; Radial n. |
|
|
Term
| What carpal bones make up the carpal tunnel? What retinaculum? Which muscles run through it? What nerve? |
|
Definition
| The distal 4 carpals and lateral two proximal (Triquetrum and Pisiform); Flexor Retinaculum; 4 tendons each of Flexor Digitorum profundus and superficialis, Flexor pollicis longus; median nerve |
|
|
Term
| Which bone pivots around the other in pronation and supination? |
|
Definition
|
|
Term
| What two nerves innervate the anterior compartment? Two for Posterior? |
|
Definition
| Median and Ulnar n.; Radial & Posterior Interosseous n. |
|
|
Term
| What muscles are innervated by the ulnar n.? |
|
Definition
| Flexor carpi ulnaris, part of flexor digitorum profundus |
|
|
Term
| Posterior Interosseous n. is a branch of what nerve? |
|
Definition
|
|
Term
| What muscle is innervated by the radial n. but does flexion? |
|
Definition
|
|
Term
| What are the 5 superficial flexor muscles? Which is actually an intermediate group? |
|
Definition
| Pronator teres, Flexor carpi radialis, Palmaris longus, Flexor carpi ulnaris, Flexor digitorum superficialis (intermediate) |
|
|
Term
| How would you treat Nursemaid's Elbow? |
|
Definition
| Best is to supinate and flex, if not, pronate and extend. |
|
|
Term
| What attachment site is inflamed with "Golfer's Elbow"? "Tennis Elbow" |
|
Definition
| Medial Epicondyle; Lateral Epicondyle |
|
|
Term
| What are the 3 Deep Flexor Muscles? |
|
Definition
| Flexor Digitorum Profundus, Flexor Pollicis Longus, Pronator Quadratus |
|
|
Term
| Name the 7 Extensor Muscles of the forearm? Where do they originate? |
|
Definition
| Barchioradialis, Ext. Carpi Radialis Longus, Ext. Carpi Radialis Brevis, Ext. Digitorum, Ext. Digiti Minimi, Ext. Carpi Ulnaris, Anconeus; Commom Extensor Tendon (Lateral Epicondyle) |
|
|
Term
| Name the 5 deep extensor muscles? Which muscles "outcrop"? |
|
Definition
| Supinator, Abductor pollicus longus, Extensor pollicus brevis, Ext. pollicis longus, Ext. indicis; Ab. pollicis longus, Ext. pollicisbrevis and longus |
|
|
Term
| What is the main cutaneous innervation for: Shoulder? Lateral Arm and Posterior Arm? Lateral Ant.Forearm? Medial Forearm? Medial hand? Lateral, Palmar hand? Lateral, Dorsal hand? |
|
Definition
| Axillary n.; Radial n.; Musculotaneous n.; Median n.; Ulnar n.; Median n.; Radial n. |
|
|
Term
| What does Colchicine do to the cell? What other pharmacology can be given? What is an alternative to these drugs? |
|
Definition
| Stops Mitotic Spindle; NSAIDs; Corticosteroid injection in joint |
|
|
Term
| Why would you treat acute gout if beginning a chronic gout therapy? |
|
Definition
| Acute flare up often occurs when beginning chronic therapy. |
|
|
Term
| What does Allopurinol and Febuxostate do in gout therapy? What drug interaction would you want to avoid? |
|
Definition
| Xanthine Oxidise Inhibitors that block uric acid formation; immunosuppression drugs |
|
|
Term
| What does Probenecid (Uricosuric) do? |
|
Definition
| Blocks URAT 1 which prevents reuptake of Uric Acid by kidneys. |
|
|
Term
| What does the Uricase enzyme do? Which drug is good for uricase treatment of gout and which for Tumor Lysis Syndrome? |
|
Definition
| Uricase is lost to humans- converts uric acid to execrable allantoin; Pegloticase = chronic gout, Rasburicase = Tumor Lysis Syndrome |
|
|
Term
| What does Cancer therapy do to increase uric acid serum levels? |
|
Definition
| Liberates Purine Nucleotides |
|
|
Term
| What 3 drugs would you give to a GR+ bug in order? |
|
Definition
| Cefazolin (1st); Ceftaroline(5th); Linzolid (Protein Synthesis Inhibitor) |
|
|
Term
| What drug would you give for a Gr- bug? |
|
Definition
|
|
Term
| Which cephalosporin is best for MRSA? MSSA? Neisseria and Lyme Disease? Bacteriodes fragilis? P. aerugnosia? |
|
Definition
| Ceftaroline; Cefazolin; Ceftriaxone; Cefoxitin; Ceftazidime and Cefapime |
|
|
Term
| What is the term for uric acid crystal deposition in subcutaneous layers, particularly ears, arms, olecranon and patella? |
|
Definition
|
|
Term
| Can Tophi deposit on internal organs? If so, where is it most common? |
|
Definition
|
|
Term
| What two organs are involved in Primary Gout? Are they due to over or under secretion? |
|
Definition
| Liver- Hyperproduction; Kidney-Hyposecretion |
|
|
Term
| At the beginning of gout, which contributes to gout more, liver or kidneys? At the end of gout? |
|
Definition
| Both; Liver (Kidneys too damaged) |
|
|
Term
| What sources of purines exacerbates gout? |
|
Definition
|
|
Term
| Where does gout first show for 90% of patients? Why there? |
|
Definition
| Tarsometatarsal joint; colder temp, especially at night (promotes crystallization) |
|
|
Term
| As Uric Acid Crystals break off into the joint capsule, what key enzymes of acute response cause inflammation and pain? |
|
Definition
| Complement and Kallikrein |
|
|
Term
| What happens to the frequency and duration of Gout bouts with treatment? |
|
Definition
|
|
Term
| What is characteristic of Pseudogout, Uric Acid or Calcium Pyrophosphate Dihydrate (CPPD) crystals? |
|
Definition
|
|
Term
| Pseudogout typically affects what demographic? What joint is often affected? |
|
Definition
| Old age(idiopathic) and trauma(secondary) to area; Knee |
|
|
Term
| Gout or Pseudogout: which is needle shaped? Which is coffin-shaped? Which seen better un polarized microscopy? |
|
Definition
|
|
Term
| What is the only source of uric acid? What helps neutralize urate build up in the blood? |
|
Definition
| Nucleotide metabolism (purines); Sodium |
|
|
Term
[image]
Explain this process? Is most uric acid pronated or depronated? Does it reasonate? |
|
Definition
| Uric Acid reduced to urea; Depronate; Resonates |
|
|
Term
| What are the 4 qualities of pain?(M.I.L.D.) |
|
Definition
| Modality, Intensity, Location, Duration |
|
|
Term
| What types of First Order Neurons from Receptive Fields can interact at Second Order Neuron? |
|
Definition
| Excitatory and Inhibitory |
|
|
Term
| What is secondary Hyperalgesia? |
|
Definition
| Increased pain stimuli that is spreading into non-damaged areas? |
|
|
Term
| Where does the Second Order Neuron receive info for pain, temp and light touch? Fine touch, Pressure, Proprioception? Where does 1st, 3rd, and 4th order synapse? |
|
Definition
| CNS; Brain Stem; Receptor Field, Thalamus, Brain |
|
|
Term
| Where is the cell body in a model neuron? Sensory Neuron? |
|
Definition
|
|
Term
| What is a TRP (Transient Receptor Potential)? What types are there? Can some receive multiple modalities of stimulation (ie- chemical and temp)? |
|
Definition
| Action potential Site for a specific stimuli; ie- temp, pain, proprioception, fine touch, light touch, and pressure; Yes |
|
|
Term
| What is TRP V1? TRP V2? TRP M8? |
|
Definition
| TRP V1- thermal and capsaicin; TRP V2- high temp; TRP M8- low temp and menthol |
|
|
Term
| What is a Nocioceptor? What are the 4 types? |
|
Definition
| Free nerve ending for pain; Temp, Mechanical, Polymodal, Silent |
|
|
Term
| What pain fiber is myelinated and fast potential for sharp pain? Which two nociceptors are this type? How would you describe the other fiber? What type of nocioceptor uses this fiber? |
|
Definition
| A-delta fiber; Temp and Mechanical; C-fiber is slow, unmyelinated and dull pain; Polymodal |
|
|
Term
| What is the only source of uric acid? What two methods bring that source into the body? What inhibits secretion? What substrate resorbs Uric Acid in the Kidneys? |
|
Definition
| Purine Nucleotide Metabolism; Diet and de-novo synthesis in liver; Alcohol and Fructose; Urate-1 |
|
|
Term
| What is "Housemaid Knees"? "Baker's Cyst"? What does "Clark's Sign" indicate? |
|
Definition
| Prepatellar Bursitis; Baker's Cyst; Clark's Sign |
|
|
Term
| Why does no pain level remain the same with muscle use with Prepatellar Bursitis? |
|
Definition
|
|
Term
| What 3 attachments of the knee are susceptible to tendonitis? |
|
Definition
| Quadriceps, Pes Anserine, ITB |
|
|
Term
| Can you sprain a muscle? Ligament? |
|
Definition
|
|
Term
| What is the "Unhappy Triad"? Why are they susceptible to injury? |
|
Definition
| ACL, TCL, Medial Meniscus; the do not naturally move very much |
|
|
Term
| A posteriorly translocated tibia will rupture the ACL or PCL? |
|
Definition
|
|
Term
| Excessive Valgus Stress with tear which ligament? |
|
Definition
| TCL (Tibial Collateral Ligament) |
|
|
Term
| Where does the femur rest in the "screw home" mechanism? |
|
Definition
|
|
Term
| Where does the patella lie on the femur at 114 degrees, medial or lateral? 14 degrees? |
|
Definition
| Medial (30-120 degrees); Lateral (0-30 degrees) |
|
|
Term
| When is the knee in a closed chain? Is an open chain the same or opposite direction? |
|
Definition
| Tibia is planted;(think of the position of when you go from sitting to standing) same direction |
|
|
Term
| What is concentric muscle movement? Eccentric? |
|
Definition
| Muscle shortens with against force; muscle lengthens under tension load |
|
|
Term
| What is the Q angle? What occurs with too much angle in either direction? |
|
Definition
| Normal alignment of Femur to Tibia; Varus or Valgus Knee |
|
|
Term
| IN terms of stability, is it static or dynamic: Ligaments? Muscles? Bone? Menisci? Tendons? |
|
Definition
Static- Ligaments, Bone, Menisci
Dynamic- Muscles and Tendons |
|
|
Term
| Is acute or chronic rotator cuff injury more common? |
|
Definition
|
|
Term
| What are 3 main factors in Chronic/Progressive Rotator Cuff injuries? |
|
Definition
| Age, Vascularity, Occupation, Leisure Activities, Posture, Bony architecture |
|
|
Term
| What is the "Gold Standard" to visualize Rotator Cuff Injuries? |
|
Definition
|
|
Term
| Is Tennis Elbow Articular or Non-Articular? |
|
Definition
| Non-articular (Lateral Epicondyle) |
|
|
Term
| What 5 (of 7) superficial forearm extensors originate from the common extensor tendon at the lateral epicondyle? |
|
Definition
| Ext. carpi radialis brevis, Ext. digitorum, Ex. digiti minimi, Ex. carpi ulnaris |
|
|
Term
| Carpal Tunnel affects more men or women? |
|
Definition
|
|
Term
| Thenar Atrophy is a sign of what? |
|
Definition
|
|
Term
| True or False: There are different Temperature Nocioreceptors for specific temp ranges. |
|
Definition
|
|
Term
| What is important about Polymodal Nocioceptors? |
|
Definition
| Multiple stimuli, especially chemical, in addition to ie- mechanical or thermal |
|
|
Term
| Is radiology helpful in diagnosing Carpal Tunnel Syndrome? |
|
Definition
|
|
Term
| How do we change the duration or intensity of pain? |
|
Definition
| Involve more nocioceptors and/or other sensory types |
|
|
Term
| What happens if SCN9A gene is inactivated? |
|
Definition
| Loss if pain sensory- inactivated sodium channels to activate it. |
|
|
Term
| Why are Prostiglandins and Bradykinin important to pain? |
|
Definition
| Activate A-delta and C fibers directly |
|
|
Term
| What does Substance P and Calcitonin gene-related peptides do? |
|
Definition
| Help neurologically transmit pain- vasodilation and histamine release |
|
|
Term
| What is the theory that suggests, for example, rubbing the skin after hitting the elbow can reduce pain by interrupting the signal pathways? |
|
Definition
| Gate Control Theory of Pain |
|
|
Term
| Explain the De Novo Process of Purine Metabolism (Hint: PRPP, Hypoanthine, Glutamine-phosphoribosylpyrophosphate). |
|
Definition
De-Novo synthesis
Ribose 5-Phosphate, fresh of the Pentose Phosphate Pathway + ATP …
Becomes Phosphoribosylpyrophosphate (PRPP)
PRPP is an "activated pentose"
Hypoanthine (Purine base) + PRPP (Ribose) = Inosine
Glutamine-phosphoribosylpyrophosphate aminotransferase
Key regulatory enzyme in Inosine production
Inosine is a tRNA anticodon for Translation
PRPP key to Purine Salvage as well |
|
|
Term
| What drug inhibits purine synthesis for gout treatment? What are some side-effects? |
|
Definition
| MTX; loss of hair, scaly skin, anemia, GI issues |
|
|
Term
| Explain the role of ATP/AMP and GTP/AMP in facilitating and inhibiting restoration of IMP to Inosine? What is the activator? Inhibitors? |
|
Definition
Key: AMP blocks use of ATP & GMP blocks GTP
ATP removes phosphate from IMP = GMP becomes GDP
GTP removes phosphate from IMP= AMP becomes ADP
Balance necessary- levels signal nucleotide breakdown
INHIBITOR: High GMP or AMP = harder to make uric acid
No phosphates
Lots of GTP and ATP = lots more uric acid
ACTIVATOR: Phosphates
Possible to introduce a competitive inhibitor |
|
|
Term
| What does HPRT do? APRT? Which is inactivated in Lesch-Nyhan Syndrome? |
|
Definition
| Restores Guanine from GDP; Restores Adenine from ADP; HPRT |
|
|
Term
| Explain the excretion process of Inosine to include allantoin due to drugs. |
|
Definition
Inosine loses Ribose group = back to Hypoxanthine
Xanthine Oxidase- adds oxygen, breaks double bonds
1st O (2 total): Hypoxanthine to Xanthine
2nd O (3 total): Xanthine to Uric Acid
Excess builds up…
Basis of gout
Urate Oxidase- adds 3rd O: (4 total):
Uric Acid to Allantoin
Not natural in Primate family
Able to better excrete
Achieved with synthetic drugs
Allopurinol
Febuxostat |
|
|
Term
| Glucose entry into glycolysis is regulated by...? |
|
Definition
|
|
Term
| What the 5 general body areas for visible/palpable masses? What are the 5 categories of pathology (C.A.N. I.T.)? |
|
Definition
| Head/Neck, Breast, Chest, Abdomen, Extremity; Congenital, Acquired, Neoplastic, Infection, Trauma |
|
|
Term
|
Definition
|
|
Term
| What lymph node is swollen with Virchow's node? Metastasis is likely where in men? Women? |
|
Definition
| Left supraclavicular node; GI tract/Lung; Breast |
|
|
Term
| What do we call a complete PE of the Head/Neck to include Pharyngoscopy, Laryngoscopy, and Upper GI Endoscopy? |
|
Definition
|
|
Term
| Would you want to punch biopsy or fine needle aspirate in the Head/Neck region? |
|
Definition
|
|
Term
| A baby born with undescended testes and los of abdominal muscles, with an expanded belly, has what syndrome? |
|
Definition
|
|
Term
| What are the 5 types of Hernias (I. L.U.V. I.)? |
|
Definition
| Inguinal, Lumbar, Umbilical, Ventral, Incisional |
|
|
Term
| In a lumbar hernia, does Grynfeltt-Lesshaft protrude from the superior or inferior lumbar triangle? What the term for the other one? |
|
Definition
|
|
Term
| Patient performs a half sit-up and has a bulge at the midline. What is it? What is the treatment? |
|
Definition
| Diastasis Recti; no surgery needed |
|
|
Term
| What are the boundaries of Petit's Lumbar Hernia? |
|
Definition
| Latissimus Dorsi, Iliac Crest, and EXTERNAL Oblique |
|
|
Term
| What are the borders of the Grynfellt-Lesshaft Lumbar Hernia? |
|
Definition
| Quadratus Lumborum, 12th Rib, and INTERNAL Oblique |
|
|
Term
| What is a special ventral hernia called that occurs at the semi-lunar line near the umbilicus? |
|
Definition
|
|
Term
| Someone on blood thinners with a red splotch on side, likely has what? |
|
Definition
| Rectus Sheath Hematoma (Spontaneous) |
|
|
Term
| For what does GIST stand (Hint: C-kit Pathway)? |
|
Definition
| Gastrointestinal Stromal Tumor |
|
|
Term
| A women comes in a with a lump in abdominal wall, that hurts during menses, what is it? |
|
Definition
|
|
Term
| What is good ergonomics for the back, arms, knees, and eyes? |
|
Definition
| Back supported, Arms parallel to ground, Knees above hips, eyes straight |
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