Musculoskeletal, skin, connective tissue (USMLE First Aid) – Flashcards
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anterior cruciate ligament origin/insertion
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lateral femoral condyle, anterior tibia
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posterior cruciate ligament origin/insertion
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medial femoral condyle, posterior tibia
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anterior drawer sign
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increased anterior tibial gliding due to ACL injury
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What constitutes and abnormal passive knee abduction test?
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lateral/valgus force causes medial space widening, indicates MCL injury
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What constitutes and abnormal passive knee adduction test?
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medial/varus force causes lateral space widening, indicates LCL injury
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Greenstick fracture pathogenesis
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incomplete fx, extends part way through bone, follows bending stress
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Torus fracture pathogenesis
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axial forced applied to immature bone, causes buckle fx of cortex
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identify the fracture
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greenstick fx
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identify the fracture
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torus fx
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Unhappy triad pathogenesis
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lateral force applied to platned leg, damages ACL, MCL, medial meniscus
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Prepatellar bursitis
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chronic trauma/pressure causes bursa inflammation
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Baker cyst pathogenesis
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popliteal fluid collection in gastrocnemius-semimembranosus bursa
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supraspinatus innervation
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suprascapular nerve
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supraspinatus action
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arm abduction initiation
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Infraspinatus innervation
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suprascapular nerve
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Infraspinatus action
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arm lateral rotation
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Supraspinatus typical injury mechanism
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trauma, degeneration, impingement
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Infraspinatus typical injury mechanism
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pitching injury
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Teres minor innervation
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axillary nerve
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Teres minor action
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arm adduction, lateral rotation
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Subscapularis innervation
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upper/lower subscapular nerves
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Subscapularis action
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arm adduction, medial rotation
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rotator cuff muscles primary spinal root innervation
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C5-C6
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what is the primary muscle/nerve responsible for arm abduction? (0-15 degrees)
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supraspinatus, suprascapular nerve
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what is the primary muscle/nerve responsible for arm abduction (150-100 degrees)
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Deltoid, axillary nerve
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what is the primary muscle/nerve responsible for arm abduction (>90 degrees)
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Trapezius, CN XI
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what is the primary muscle/nerve responsible for arm abduction (>100 degrees)
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Serratus anterior, long thoracic nerve
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medial epicondylitis alternate name
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golfers elbow
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medial epicondylitis pathogenesis
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repetitive flexion causes pain over medial epicondyle
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lateral epicondylitis alternate name
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tennis elbow
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lateral epicondylitis pathogenesis
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repetitive extensionc causes pain near lateral epicondyle
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Scaphoid significant associated pathologies
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most commonly fx via FOSH, may cause osteonecrosis, nonunion
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Lunate dislocation complications
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acute CTS
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Carpal tunnel syndrome (CTS) pathogenesis
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carpal tunnel compresses median nerve
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Carpal tunnel syndrome (CTS) clinical presentation
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paresthesia, pain, numbness in median nerve distribution, thenar atrophy
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Carpal tunnel syndrome (CTS) risk factors
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repetitive use, pregnancy, RA, hypothyroid, DM, acromegaly, dialysis related amyloidosis
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Carpal tunnel syndrome (CTS) diagnostic signs
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Tinel sign, phalen test
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Guyon canal syndrome pathogenesis
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ulnar nerve compression at wrist/hand
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Guyon canal syndrome risk factors
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cycling due to handlebar pressure
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identify the pathology
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ACL tear
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identify the pathology
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prepatellar bursitis
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identify the pathology
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baker cyst
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identify the pathology
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supraspinatus tear
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identify the bone
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1st metacarpal
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identify the bone
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capitate
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identify the bone
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Hamate
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identify the bone
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Lunate
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identify the bone
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Pisiform
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identify the bone
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Scaphoid
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identify the bone
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trapezium
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identify the bone
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trapezoid
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identify the bone
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triquetrum
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Axillary nerve spinal roots
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C5-6
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Axillary nerve most common mechanism of injury
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humerus surgical neck fx, anterior dislocation
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Axillary nerve injury clinical presentation
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flattened deltoid, no arm abduction >15 degrees, deltoid/lateral arm anesthesia
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Musculocutaneous nerve spinal roots
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C5-7
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Musculocutaneous nerve most common mechanism of injury
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upper trunk compression
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Musculocutaneous nerve injury clinical presentation
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no forearm flexion, supination, lateral forearm anesthesia
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Radial nerve spinal roots
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C5-T1
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Radial nerve most common mechanism of injury
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midshaft humeral fx, axillary compression
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Radial nerve injury clinical presentation
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no elbow, wrist, finger extension, decreased grip strength, posterior arm, forearm, dorsal hand anesthesia
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Median nerve spinal roots
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C5-T1
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Median nerve most common mechanism of injury
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supracondylar humeral fx, CTS, wrist laceration
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Median nerve injury clinical presentation
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ape hand, no wrist, lateral finger flexion, thumb opposition, dorsal/palmar hand anesthesia
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Median nerve injury clinical presentation
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no wrist flexion medial finger flexion, abduction/adduction, medial 1.5 fingers, hypothenar anesthesia
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recurrent branch of median nerve spinal roots
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C5-T1
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recurrent branch of median nerve most common injury mechanism
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superficial palm laceration
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recurrent branch of median nerve injury clinical presentation
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ape hand, loss of thenar muscle group
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Erb palsy alternate name
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Waiter's tip
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Erb palsy pathogenesis
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traction/tear of upper brachial plexus trunks, C5-6 roots
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Erb palsy injury mechanism (infants)
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lateral neck traction during delivery
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Erb palsy injury mechanism (adults)
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trauma
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Erb palsy muscles affected
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deltoid, supraspinatus, infraspinatus, biceps brachii
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Erb palsy functional deficits
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loss of arm abduction, lateral rotation, forearm flexion, supination
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Klumpke palsy: pathogenesis
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traction/tear of brachial plexus lower trunk, C8-T1
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Klumpke palsy: injury mechanism (infants)
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upward force on arm during delivery
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Klumpke palsy: injury mechanism (adults)
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trauma (grabbing branch to break fall)
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Klumpke palsy: muscles affected
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intrinsic hand muscles: lumbricals, interossei, thenar, hypothenar
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Klumpke palsy: functional deficits
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total claw hand
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Thoracic outlet syndrome pathogenesis
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compression of brachial plexus lower trunk, subclavian vessels
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Thoracic outlet syndrome mechanism of injury
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cervical rib, pancost tumor
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Thoracic outlet syndrome muscles affected
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intrinsic hand muscles: lumbricals, interossei, thenar, hypothenar
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Thoracic outlet syndrome: functional deficits
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intrinsic hand muscle atrophy, ischemia, pain, edema
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Winged Scapula pathogenesis
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long thoracic nerve lesion
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Winged Scapula mechanism of injury
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axillary node dissection after mastectomy, stab wounds
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Winged Scapula muscles affected
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serratus anterior
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Winged Scapula functional deficits
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iniability to anchor scapula to thoracic cage, loss of end arm abduction
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identify the clinical finding and associated pathology
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Waiters tip deformity, Erb palsy
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identify the clinical finding and associated pathology
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Claw hand, Klumpke palsy
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identify the clinical finding and associated pathology
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cervical rib, thoracic outlet syndrome
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identify the clinical finding and associated pathology
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winged scapula, long thoracic nerve injury
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Clawing of hands anatomical mechanism
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extrinsic digital flexors exaggerate lumbrical loss: MCP extension, DIP, PIP flexion
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identify the clinical finding and the associated pathology (patient was asked to extend fingers)
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ulnar claw, distal ulnar nerve lesion
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identify the clinical finding and the associated pathology (patient was asked to make a fist)
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pope's blessing, proximal median nerve lesion
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identify the clinical finding and the associated pathology (patient was asked to extend fingers)
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median claw, distal median nerve lesion
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identify the clinical finding and the associated pathology (patient was asked to make a fist)
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OK gesture, proximal ulnar nerve lesion
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name thanar muscles
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opponens, pollicis, abductor pollicis brevis, flexor pollicis brevis
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name the hypothenar muscles
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opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis
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name the intrinsic hand muscles (not including thenar/hypothenar groups)
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dorsal/palmar interossei, lumbricals
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Dorsal interossei muscles action
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finger abduction
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Palmar interossei muscles action
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finger adduction
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Lumbricals muscles action
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MCP flexion, PIP/DIP extension
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Acetaminophen MOA
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reversibly inhibits COX in CNS, (inactivated peripherally)
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Acetaminophen physiologic effects
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antipyretic, analgesic, not anti-inflammatory
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Acetaminophen clinical uses
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fever, pain, use instead of ASA to avoid Reye syndrome
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Acetaminophen adverse effects
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hepatic necrosis
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Acetaminophen hepatotoxicity pathophysiology
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metabolite depletes glutathione, forms toxic byproducts, causes necrosis
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Acetaminophen hepatotoxicity treatment
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N-acetylcysteine, regenerates glutathione
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Aspirin MOA
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irreversibly inhibits COX 1/2, decreases prostaglandin, TXA2 synthesis
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Aspirin effect on coagulation labs
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prolonged bleeding time, normal PT, PTT, lasts until new platelets produced
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low dose aspirin clinical uses
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platelet aggregation inhibition (anticoagulation)
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intermediate dose aspirin clinical uses
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antipyretic, analgesic
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high dose aspirin clinical uses
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antiinflammatory
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Aspirin adverse effects
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gastric ulcers, tinnitus, nephrotoxicity, reye syndrome
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Aspirin toxicity pathophysiology
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initial respiratory alkalosis, transitions to compensated metabolic acidosis
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Aspirin adverse effects: renal
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acute renal failure, interstitial nephritis
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Celecoxib MOA
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selectively inhibits COX2
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COX-2 function
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found in inflammatory cells, vascular endothelium, mediates inflammation, pain
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Celecoxib beneficial effects
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anti-inflammatory w/o GI irritation, spares platelet function
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Celecoxib clinical uses
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RA, osteoarthritis
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Celecoxib adverse effects
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increased thrombosis risk, sulfa allergy
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Ibuprofen drug class
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NSAID
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Naproxen drug class
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NSAID
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Indomethacin drug class
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NSAID
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Ketorolac drug class
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NSAID
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Diclofenac drug class
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NSAID
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Piroxicam drug class
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NSAID
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NSAIDs (Ibuprofen) MOA
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reversibly inhibits COX 1/2, prostaglandin synthesis
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NSAIDs (Ibuprofen) clinical uses
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antipyretic, analgesic, anti-intlammatory
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Indomethacin unique clinical uses
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close PDA in neonate
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NSAIDs (Ibuprofen) adverse effects
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PUD, aplastic anemia, interstitial nephritis, renal ischemia
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Leflunomide MOA
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reversibly inhibits dihydroorotate dehydrogenase, inhibits pyrimidine synthesis, T cell proliferation
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Leflunomide clnical uses
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RA, psoriatic arthritis
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Leflunomide adverse effects
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diarrhea, HTN, hepatotoxicity, teratogen
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"-dronate" drug class
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bisphosphonate
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Alendronate drug class
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bisphosphonate
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Ibandronate drug class
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bisphosphonate
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Zoledronate drug class
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bisphosphonate
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Bisphosphonates (Alendronate) MOA
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pyrophosphate analog, binds bone hydroxyapatite, inhibits osteoclasts
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Bisphosphonates (Alendronate) clincial uses
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osteoporosis, hypercalcemia, Pagets disease, bone metastasis, osteogenesis imperfecta
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Bisphosphonates (Alendronate) adverse effects
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esophagitis, jaw osteonecrosis, atypical stress fx
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Bisphosphonates (Alendronate) administration instructions
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take w/ H2O, remain upright for 30 minutes
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Teriparatide MOA
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recombinant PTH analog, increases osteoblast activity
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Teriparatide absorption
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SQ
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Teriparatide clinical uses
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osteoporosis, causes increased bone growth
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Teriparatide adverse effects
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osteosarcoma risk, transient hypercalcemia
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Teriparatide contraindications
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hx of cancer, radiation therapy
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Allopurinol drug class
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xanthine oxidase inhibitor
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Febuxostat drug class
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xanthine oxidase inhibitor
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Xanthine oxidase inhibitors (Allopurinol) MOA
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inhibits conversion of xanthine to urate
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Xanthine oxidase inhibitors (Allopurinol) clinical uses
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chronic gout, leukemia/lymphoma tumor lysis syndrome
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Pegloticase MOA
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recombinant uricase, converts urate to allantoin
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Pegloticase clinical uses
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chronic gout
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Probenecid MOA
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inhibits PCT urate reabsorption
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Probenecid adverse effects
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uric acid calculi
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Colchicine MOA
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stabilizes tubulin, inhibits microtubule polymerization, inhibits neutrophil chemotaxis, degranulation
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Colchicine clinical uses
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acute/prophylactic gout
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Colchicine adverse effects
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GI effects
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Drugs used for acute gout attacks
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NSAIDS, steroids, colchicine
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TNF-alpha inhibitors adverse effects
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infection risk, latent TB reactivation
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Etanercept drug class
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TNF-alpha inhibitor
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Etanercept MOA
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soluble TNF receptor + IgG Fc, binds TNF
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Etanercept clinical uses
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RA, psoriasis, ankylosing spondylitis
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Infliximab drug class
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TNF-alpha inhibitor
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Adalimumab drug class
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TNF-alpha inhibitor
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Certolizumab drug class
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TNF-alpha inhibitor
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Golimumab drug class
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TNF-alpha inhibitor
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TNF-alpha inhibitor monoclonal antibodies (Infliximab) clinical uses
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IBD, RA, ankylosing spondylitis, psoriasis
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Iliohypogastric nerve spinal cord roots
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T12-L1
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Genitofemoral nerve spinal cord roots
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L1-L2
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Lateral femoral cutaneous nerve spinal cord roots
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L2-L3
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Obturator nerve spinal cord roots
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L2-L4
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Femoral nerve spinal cord roots
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L2-L4
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Sciatic nerve spinal cord roots
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L4-S3
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Common peroneal nerve spinal cord roots
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L4-S2
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Tibial nerve spinal cord roots
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L4-S3
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Iliohypogastric nerve sensory innervation
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suprapubic
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genitofemoral nerve sensory innervation
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scrotum/labia majora, medial thigh
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Lateral femoral cutaneous nerve sensory innervation
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anterior, lateral thigh
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Obturator nerve sensory innervation
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medial thigh
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Femoral nerve sensory innervation
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anterior thigh, medial leg
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Sciatic nerve sensory innervation
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Posterior thigh
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common peroneal nerve sensory innervation
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dorsum of foot
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Tibial nerve sensory innervation
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sole of foot
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Iliohypogastric nerve motor innervation
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transversus abdominis, internal oblique
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Genitofemoral nerve motor innervation
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cremaster
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Obturator nerve motor innervation
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obturator externus, adductor longus/brevis/magnus, gracilis, pectineus,
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Femoral nerve motor innervation
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quadriceps, iliopsoas, pectineus, sartorius
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Sciatic nerve motor innervation
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hamstrings, adductor magnus
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Common peroneal nerve motor innervation
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biceps femoris, tibialis anterior, foot extensors
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Tibial nerve motor innervation
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triceps surae, plantaris, popliteus, foot flexors
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Iliohypogastric nerve most common cause of injury
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abd surgery
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Genitofemoral most common cause of injury
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laparoscopic surgery
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Lateral femoral cutaneous nerve most common cause of injury
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tight clothing, obesity, pregnancy
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Obturator nerve most common cause of injury
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Pelvic surgery
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Femoral nerve most common cause of injury
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pelvic fx
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Sciatic nerve most common cause of injury
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herniated disc
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Common peroneal nerve most common cause of injury
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Trauma, compress of lateral leg, fibular neck fx
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Tibial nerve most common cause of injury
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knee trauma, baker cyst, tarsal tunnel syndrome
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Iliohypogastric nerve injury clinical presentation
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burning/tingling in incision site, radiates to inguinal, suprapubic region
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Genitofemoral nerve injury clinical presentation
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decreased anterior thigh sensation beneath inguinal ligament, absent cremaster reflex
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Lateral femoral cutaneous nerve injury clinical presentation
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decreased thigh sensation
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Obturator nerve injury clinical presentation
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decreased thigh sensation, adduction
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Femoral nerve injury clinical presentation
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decreased thigh flexion, leg extension
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Common peroneal nerve injury clinical presentation
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decreased dorsal foot sensation, foot drop
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Tibial nerve injury clinical presentation
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decreased plantar foot sensation, foot inversion, plantarflexion
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Superior gluteal nerve motor innervation
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gluteus medius/minimus, TFL
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Inferior gluteal nerve motor innervation
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gluteus maximus
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Pudendal nerve sensory innervation
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perineum
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Pudendal nerve motor innervation
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external urethral/anal sphincter
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Superior gluteal nerve spinal cord roots
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L4-S1
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inferior gluteal nerve spinal cord roots
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L5-S2
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Pudendal nerve spinal cord roots
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S2-S4
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Superior gluteal nerve most common cause of injury
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Iatrogenic via intramuscular injection
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Inferior gluteal nerve most common cause of injury
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posterior hip dislocation
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Pudendal nerve most common cause of injury
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Stretch injury during childbirth
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Superior gluteal nerve injury clinical presentation
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trendelenburg gait/sign, drop is c/l to lesion
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Inferior gluteal nerve injury clinical presentation
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decreased hip extension, difficulty climbing stairs, rising from seated,
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Pudendal nerve injury clinical presentation
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saddle anesthesia, incontinence
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gluteus medius action (at hip)
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abduction, internal rotation
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gluteus minimus action (at hip)
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abduction, internal rotation
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Adductor magnus/longus/brevis action (at hip)
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adduction
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Gluteus maximus action (at hip)
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extension, external rotation
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semitendinosus action (at hip)
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extension
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semimembranosus action (at hip)
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extension
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Iliopsoas action (at hip)
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flexion, external rotation
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Rectus femoris action (at hip)
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flexion
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Tensor fascia lata action (at hip)
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flexion, internal rotation
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piriformis action (at hip)
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external rotation
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Obturator internus/externus action (at hip)
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external rotation
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what direction to intervertebral discs typically herniate?
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posterolateral
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if the L3-L4 intervertebral disc herniates, what clinical findings would be expected?
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weak knee extension, decreased patellar reflex
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if the L4-L5 intervertebral disc herniates, what clinical findings would be expected?
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weak dorsiflexion, difficulty heel walking
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if the L5-S1 intervertebral disc herniates, what clinical findings would be expected?
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weak plantar flexion, difficulty toe walking, decreased calcaneal reflex
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what nerve/artery (respectively) is associated with the axilla/lateral thorax?
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long thoracic N, lateral thoracic A
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what nerve/artery (respectively) is associated with the surgical neck of humerus?
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axillary N, posterior circumflex A
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what nerve/artery (respectively) is associated with the midshaft humerus?
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radial N, deep brachial A
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what nerve/artery (respectively) is associated with the distal humerus/cubital fossa?
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median N, brachial A
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what nerve/artery (respectively) is associated with the popliteal fossa?
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tibial N, popliteal A
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what nerve/artery (respectively) is associated with the posterior medial malleolus?
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tibial N, posterior tibial A
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answer
M line
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answer
myosin
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answer
sarcomere
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answer
T tubule
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skeletal muscle triad
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T tubule + 2 terminal cisternae
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cardiac muscle dyad
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T tubule + 1 terminal cisterna
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type 1 muscle fiber characteristics
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slow twitch, red, aerobic, high mitochondria, Mb
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type 2 muscle fiber characteristics
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fast twitch, white, anerobic, low mitochondria, Mb
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if the myosin light chain kinase is active, does this cause smooth muscle to contract or relax?
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contract
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if the myosin light chain phosphorylase is active, does this cause smooth muscle to contract or relax?
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relax
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which bones undergo endochondral ossification
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axial/appendicualr skeleton, base of sull
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which bones undergo membranous ossification?
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calvarium, facial bones, clavicle
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endochondrial ossification mechanism
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cartilage replaced with woven bone, later replaced with lamellar bone
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membranous ossification mechanism
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woven bone formed directly w/o cartilage, remodeled to lamellar bone
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Osteoblast function
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builds bone via secreting collagen, catalyzing mineralization, produces ALP
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Osteoblast cell of origin
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mesenchymal stem cells in periosteum
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what lab tests are used to measure osteoblast activity?
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ALP, osteocalcin, type I procollagen propeptides
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Osteoclast function
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secretes H+, collagenases to dissolve bone
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Osteoclast cell of origin
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fusion of monocyte/macrophage precursors
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PTH function (low concentration)
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anabolic effects on osteoblasts/osteoclasts, induces bone building
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PTH function (high concentration)
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catabolic effects: osteitis fibrosa cystica
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Estrogen effect on bone
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inhibits osteoblast apoptosis, induces osteoclast apoptosis, causes epiphyseal plate closure during puberty
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Achondroplasia pathogenesis
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defective endochondral ossification, longitudinal bone growth causes short limbs, membranous ossification affected
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Achondroplasia clinical presentation
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large head relative to limbs
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Achondroplasia molecular pathogenesis
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constitutive activation of FGFR3, inhibits chondrocyte proliferation
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Achondroplasia inheritance
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AD, full penetrance, homozygous is lethal
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Osteoporosis pathogenesis
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trabecular/spongy bone loses mass, interconnections, due to increased bone resorption, decreased estrogen
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Osteoporosis treatment
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eight bearing exercise, adequate Ca2+, vitamin D, bisphosphonates, teriparatide, SERMs, calcitonin
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identify the clinical finding and associated pathology
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vertebral compression fx, osteoporosis
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Osteopetrosis pathogenesis
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defective osteoclasts cause abnormal bone resorption, leads to thickened dense bones, prone to fx
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Osteopetrosis complications
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fx, thikened bone causes decreased marrow, pancytopenia, cranial nerve impingement
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Osteopetrosis treatment
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bone marrow transplant
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Osteomalacia/rickets pathogenesis
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defective osteoid/growth plate mineralization
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Osteomalacia/rickets most common etiology
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vitamin D deficiency
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Osteomalacia clinical presentation
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osteopenia, pseudofractures
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rickets clinical presentation
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epiphyseal widening, metaphyseal cupping, genu varum, bead-like costochondral junctions, craniotabes
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Osteomalacia/rickets lab findings
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decreased vitamin D, Ca2+, PO4, increased PTH, ALP
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Paget disease of bone (osteitis deformans) pathogenesis
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increased osteoclast activity followed by disorganized osteoblast activity, forms poor quality bone
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Paget disease of bone (osteitis deformans) laboratory findings
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increased Ca2+, PO4, PTH, ALP
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Paget disease of bone (osteitis deformans) clinical presentation
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mosaic pattern of woven/lamellar bone, long bone chalk stick fx
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Paget disease of bone (osteitis deformans) complications
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high output CHF due to AV shunts, osteogenic sarcoma
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lytic phase of Paget disease of bone (osteitis deformans)
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osteoclast activity
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mixed phase of Paget disease of bone (osteitis deformans)
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osteoclast/osteoblast activity
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Sclerotic phase of Paget disease of bone (osteitis deformans)
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osteoblast activity
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Quiescent phase of Paget disease of bone (osteitis deformans)
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minimal osteoblast/osteoclast activity
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Paget disease of bone (osteitis deformans) treatment
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bisphosphonates
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Osteonecrosis (avascular necrosis) pathogenesis
answer
bone/marrow infarction via ischemia
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Osteonecrosis (avascular necrosis) etiology
answer
steroids, alcoholism, sickle cell, trauma, the bends, LCP/SCFE, Gaucher disease
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identify the clinical finding and associated pathology
answer
bead-like costochondral junctions, rickets
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identify the clinical finding and associated pathology
answer
genu varum, rickets
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identify the clinical finding and associated pathology
answer
skull thickening, paget disease of bone
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identify the pathology
answer
osteonecrosis
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osteoporosis lab findings
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normal electrolytes/hormones, decreased bone lab
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Osteopetrosis lab findings
answer
normal/decreased CA2+ if severe
question
Paget disease of bone lab findings
answer
increased ALP
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Osteitis fibrosa cystica (primary hyperparathyroidism) lab findings
answer
increased Ca2+, AlP, PTH, decreased PO4
question
secondary hyperparathryoidism lab findings
answer
increased PO4, ALP, PTH, decreased Ca2+
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Osteomalacia/rickets lab findings
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increased ALP, PTH, decreased Ca2+, PO4
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Hypervitaminosis D lab findings
answer
increased Ca2+, PO4, decreased PTH
question
Osteitis fibrosa cystica clinical presentation
answer
brown tumors, subperiosteal thinning
question
Osteitis fibrosa cystica etiology
answer
idiopathic, parathyroid hyperplasia/adenoma/carcinoma
question
hypervitaminosis D etiology
answer
oversupplementation, granulomatous disease
question
Osteochondroma characteristics
answer
bony exostosis with cartilagenous cap
question
Osteochondroma complications
answer
fx, arely transforms to chondrosarcoma
question
Giant cell tumor of bone most common location of origin
answer
long bone epiphysis, especially distal femur, proximal tibia
question
Giant cell tumor of bone typical behavior
answer
locally aggressive, benign
question
Giant cell tumor of bone radiographic morphology
answer
soap bubble
question
Giant cell tumor of bone histologic morphology
answer
giant cells, express RANKL
question
Osteosarcoma risk factors
answer
paget disease, bone infarcts, radiation, familal retinoblastoma, Li-fraumeni syndrome
question
Osteosarcoma most common site of origin
answer
metaphysis of long bones
question
Osteosarcoma radiographic morphology
answer
Codman triangle, sunburst pattern
question
Osteosarcoma typical behavior
answer
aggressive
question
Ewing sarcoma risk factors
answer
children <15
question
Ewing sarcoma typical location of origin
answer
long bone diaphysis, pelvis, scapula, ribs
question
Ewing sarcoma histologic morphology
answer
anaplastic, small round blue cells
question
Ewing sarcoma typical vehavior
answer
extremely aggressive, early mets, responsive to chemo
question
Ewing sarcoma molecular pathogenesis
answer
t11:22 causes EWS-FLI1 fusion protein
question
identify the pathology
answer
osteochondroma
question
identify the clinical finding and associated pathology
answer
soap bubble, giant cell tumor
question
identify the pathology
answer
osteosarcoma
question
identify the clinical finding and associated pathology
answer
anaplastic small blue cells, ewing sarcoma
question
what type of bone lesion typically forms here?
answer
ewing sarcoma, myeloma
question
what type of bone lesion typically forms here?
answer
fibrous dysplasia
question
what type of bone lesion typically forms here?
answer
giant cell tumor
question
what type of bone lesion typically forms here?
answer
osteochondroma
question
what type of bone lesion typically forms here?
answer
osteoid osteoma
question
what type of bone lesion typically forms here?
answer
osteosarcoma
question
what type of bone lesion typically forms here?
answer
simple bone cyst
question
osteoarthritis pathogenesis
answer
mechanical damage destroys articular cartilage, infalmmation w/ inadequate repair, chondrocytes mediate degradation
question
osteoarthritis risk factors
answer
age, female, obesity, joint trauma
question
osteoarthritis clinical presentation
answer
asymmetric pain in weight bearing joints, worse after use, better with rest
question
osteoarthritis joint findings
answer
osteophytes, joint space narrowing, subchondral sclerosis/cysts, noninflammatory fluid, involves DIP, PIP, 1st CMC joints, no MCP
question
osteoarthritis treatment
answer
acetaminophen, NSAIds, glucocorticoids
question
Rheumatoid arthritis pathogenesis
answer
autoimmune: inflammation produces pannus, erodes articular cartilage/bone
question
Rheumatoid arthritis risk factors
answer
female, HLA DR4, smoking, silica exposure
question
Rheumatoid arthritis lab findings
answer
rheumatoid factor, anti-CCP antibody
question
Rheumatoid arthritis clinical presentation
answer
symmetric pain, swelling, morning stiffness, improves w/ use, extraarticular manifestations
question
Rheumatoid arthritis joint findings
answer
erosions, juxta-articular osteopenia, soft tissue swelling, subchondral cysts, joint space narrowing, involves MCP, PIP, wrist, not DIP, 2st CMC
question
Rheumatoid arthritis assocaited deformities
answer
cervical subluxation, ulnar finger deviation, swan neck/boutonniere deformity, i
question
Rheumatoid arthritis treatment
answer
NSAIDs, glucocorticoids, DMARDs
question
identify the clinical finding and associated pathology
answer
Pannus, RA
question
identify the clinical finding and associated pathology
answer
heberden nodes, OA
question
identify the clinical finding and associated pathology
answer
bouchard nodes, OA
question
identify the clinical finding and associated pathology
answer
swan neck deformity, RA
question
identify the clinical finding and associated pathology
answer
boutonniere deformity, RA
question
Gout pathogenesis
answer
monosodium urate precipitation in joints cause inflammation, pain
question
what diseases can cause gout via underexcretion of uric acid?
answer
idiopathic, renal failure, certain meds (thiazides)
question
what diseases can cause gout via overproduction of uric acid?
answer
lesch-nyhan syndrome, PRPP excess, tumor lysis syndrome, von Gierke disease
question
Gout histologic morphology
answer
needl shaped cristals, negatively birefringent under polarized light
question
gout clinical presentation
answer
asymmetric joint swelling, redness, pain
question
acute gout treatment
answer
NSAIDs, glucocorticoids, colchicine
question
chronic gout treatment
answer
xanthine oxidase inhibitor
question
identify the clinical finding and associated pathology
answer
urate crystals, gout
question
identify the clinical finding and associated pathology
answer
urate crystals, gout
question
identify the clinical finding and associated pathology
answer
tophus, gout
question
identify the clinical finding and associated pathology
answer
calcium pyrophosphate cyrstals in joint space, CPPD disease
question
identify the clinical finding and associated pathology
answer
calcium pyrophosphate crystals, CPPD disease
question
Calcium pyrophosphate deposition disease (CPPD disease) pathogenesis
answer
calcium pyrophosphate crystals deposit in joint space
question
Calcium pyrophosphate deposition disease (CPPD disease) risk factors
answer
hemochromatosis, hyperparathyroidism, joint trauma
question
Calcium pyrophosphate deposition disease (CPPD disease) most commonly affected joint
answer
knee
question
Calcium pyrophosphate deposition disease (CPPD disease) radiographic findings
answer
chondrocalcinosis
question
Calcium pyrophosphate deposition disease (CPPD disease) acute treatment
answer
NSAIDs, colchicine, glucocorticoids
question
Calcium pyrophosphate deposition disease (CPPD disease) chronic/preventative treatment
answer
colchicine
question
Sjögren syndrome pathogenesis
answer
autoimmune destruction of exocrine glands, especially lacrimal, sailvary
question
Sjögren syndrome histologic morphology
answer
lymphocytic infiltrates
question
Sjögren syndrome clinical presentation
answer
inflammatory joint pain, keratoconjunctivitis sicca, xerostomia, b/l parotid enlargement
question
Sjögren syndrome lab findings
answer
ANA, rheumatoid factor, SS-A, SS-B
question
Sjögren syndrome complications
answer
dental caries, MALToma
question
most common causes of septic arthritis
answer
S. aureus, strep, N. gonorrhoeae
question
septic arthritis clinical presentation
answer
joint swelling, redness, pain
question
septic arthritis lab findings
answer
synovial WBCS >50,000
question
Gonococcal arthritis clinical presentation
answer
purulent arthritis or polyarthralgia, tenosynovitis, dermatitis
question
identify the clinical finding and associated pathology
answer
lymphocytic infiltrate, sjogren syndrome
question
identify the clinical finding and associated pathology
answer
xerostomia, sjogren syndrome
question
identify the pathology
answer
septic arthritis
question
seronegative spondyloarthritis risk factors
answer
HLA B27
question
seronegative spondyloarthritis common clinical presentation
answer
inflammatory back pain, peripheral arthritis, enthesitis, dactylitis, uveitis
question
Psoriatic arthritis clinical presentation
answer
skin psoriasis, nail lesions, asymmetric patchy involvement, dactylitis, pencil in cup deformity
question
Ankylosing spondylitis clinical presentation
answer
symmetric spine/SI joint involvement, ankylosis, uveitis, aortic regurg
question
classic traid of reactive arthritis
answer
conjunctivitis, urethritis, arthritis
question
which pathogens are associated with reactive arthritis?
answer
shigella, salmonella, yersinia, chlamydia, campylobacter
question
identify the clinical finding and associated pathology
answer
dactylitis, psoriatic arthritis
question
identify the clinical finding and associated pathology
answer
pencil in cup deformity, psoriatic arthritis
question
identify the clinical finding and associated pathology
answer
bamboo spine, psoriatic arthritis
question
Ankylosing spondylitis copmlications
answer
restrictive lung disease
question
Systemic lupus erythematosus clinical presentation (classic)
answer
rash, joint, pain, fever
question
Libman-Sacks endocarditis (SLE complications)
answer
nonbacterial verrucous thrombi on mitral/aortic valve
question
Systemic lupus erythematosus complications
answer
Libman-Sacks endocarditis, nephritis, CV disease, infections
question
Systemic lupus erythematosus clinical presentation
answer
rash, arthritis, serositis, hematologic/renal/neurologic disorders, photosensitivity
question
Systemic lupus erythematosus lab findings
answer
ANA, anti-dsDNA, anti-Smith, antiphospholipid, decreased C3, C4, CH50
question
What does the presence of anti-dsDnA antibodies indicate? (SLE)
answer
poor prognosis due to renal disease
question
What does the presence of anti-histone antibodies indicate? (SLE)
answer
sensitive for drug induced SLE
question
Antiphospholipid syndrome pathogenesis
answer
anticardiolipin antibodes cause increased thrombosis, spontaneous abortion, false positive VDRL/RPR
question
Antiphospholipid syndrome laboratory findings
answer
lupus anticoagulant, anticardiolipin, anti-beta 2 glycoprotein antibdoesi
question
Antiphospholipid syndrome treatment
answer
anticoagulation
question
mixed connective tissue disease characteristics
answer
features of SLE, systemic sclerosis, polymyositis
question
mixed connective tissue disease lab findings
answer
anti-U1 RNP antibodies
question
Sarcoidosis pathogenesis
answer
immune mediated noncaseating granulomas
question
Sarcoidosis lab findings
answer
increased ACE, CD4/CD8 ratio in bronchoalveolar fluid
question
Sarcoidosis radiographic findings
answer
XR: b/l adenopathy, coarse reticular opacities, CT: extensive hilar/mediastinal adenopathy
question
Sarcoidosis complications
answer
restrictive lung disease, erythema nodosum, lupus pernio, bell's palsy, epithelioid granulomas, uveitis, hypercalcemia
question
identify the clinical finding and associated pathology
answer
malar rash, SLE
question
identify the clinical finding and associated pathology
answer
discoid rash, SLE
question
identify the clinical finding and associated pathology
answer
noncaseating granulomas, sarcoidosis
question
identify the clinical finding and associated pathology
answer
coarse reticular opacities, sarcoidosis
question
identify the clinical finding and associated pathology
answer
hilar/mediastinal adenopathy, sarcoidosis
question
polymyalgia rheumatica clinical presentation
answer
pain/stiffness in shoulders/hips, fever, malaise, weight loss, no weakness
question
polymyalgia rheumatica disease associations
answer
giant cell arteritis
question
polymyalgia rheumatica lab findings
answer
increased ESR, CRP, normal CK
question
polymyositis/dermatomyositis lab findings
answer
increased CK, + ANA, anti-Jo-1, anti-SRP, anti-Mi-2 antibodies
question
polymyositis/dermatomyositis treatment
answer
steroids, long term immunosuppression
question
Polymyositis clinical presentation
answer
progressive symmetric proximal muscle weakness, commonly involves shoulders
question
Polymyositis histologic morphology
answer
endomysial inflammation w/ CD8 T cells
question
Dermatomyositis clinical presentation
answer
polymyositis + malar rash, grotton papules, heliotrope rash
question
Dermatomyositis complications
answer
occult malignant
question
Dermatomyositis histologic morphology
answer
perimysial inflammation, atrophy w/ CD4 T cells
question
Myasthenia gravis pathogenesis
answer
autoantibodies to postsynaptic Ach receptor
question
Myasthenia gravis clincial presentation
answer
ptosis, diplopia, weakness, worse with use, better with edrophonium
question
Myasthenia gravis disease associations
answer
thymoma, thymic hyperplasia
question
Myasthenia gravis interaction with AchE inhibitor
answer
improves sx
question
Lambert-Eaton Myasthenic syndrome pathogenesis
answer
autoantibodies to presynaptic Ca2+ channel, decreases Ach release
question
Lambert-Eaton Myasthenic syndrome clinical presentation
answer
proximal muscle weakness, autonomic sx, improves with muscle use
question
Lambert-Eaton Myasthenic syndrome disease associations
answer
small cell lung cancer
question
Lambert-Eaton Myasthenic syndrome interaction with AchE inhibitors
answer
minimal effect
question
Raynaud phenomenon pathophysiology
answer
arteriolar vasospasm in response to cold/stress causes decreased skin blood flow, color change
question
difference between raynaud disease and raynaud syndrome
answer
disease=primary, syndrome=secondary
question
Raynaud syndrome (secondary) complciations
answer
digital ulceration
question
Raynaud disease/syndrome treatment
answer
calcium channel blocker
question
identify the clinical finding and associated pathology
answer
grotton's papules, dermatomyositis
question
identify the clinical finding and associated pathology
answer
heliotrope rash, dermatomyositis
question
identify the clinical finding and associated pathology
answer
shawl/face rash, dermatomyositis
question
identify the pathology
answer
Raynaud phenomenon
question
Scleroderma (systemic sclerosis) pathogenesis
answer
autoimmun, noninflammatory vasculopathy, collagen deposition with fibrosis
question
Scleroderma (systemic sclerosis) clinical presentation
answer
skin sclerosis causes puffy taut skin, fingertip pitting
question
Scleroderma (systemic sclerosis) complications
answer
renal, pulmonary, CV, GI sclerosis causes death
question
Diffuse scleroderma disease severity
answer
widespread skin involvement, rapid progression, early visceral involvement
question
Limited scleroderma disease severity
answer
limited skin involvement, confined tin fingers, face
question
Diffuse scleroderma lab findings
answer
anti-Scl-70/DNA topoisomerase I antibody
question
CREST syndrome (acronym)
answer
calcinosis, Raynaud phenoemon, esophageal dysmotility, sclerodactyly, telangiectasia
question
limited scleroderma/CREST syndrome lab findings
answer
anti-centromere antibody
question
identify the clinical finding and associated pathology
answer
puffy, taut skin, scleroderma
question
identify the clinical finding and associated pathology
answer
fingertip pitting, scleroderma
question
identify the clinical finding and associated pathology
answer
calcinosis, scleroderma/CREST syndrome
question
identify the layer indicated by C
answer
stratum corneum
question
identify the layer indicated by L
answer
stratum lucidum
question
identify the layer indicated by G
answer
stratum granulosum
question
identify the layer indicated by S
answer
stratum spinosum
question
identify the layer indicated by B
answer
stratum basale
question
tight junctions function
answer
prevents paracellular solute movement
question
tight junctions structural components
answer
claudins, occludins
question
Adherens junctions function
answer
forms belt that connects actin cytoskeletons of adjacent cells
question
Adherens junctions structural components
answer
Cadherins
question
Desmosomes function
answer
structural support
question
Desmosomes structural components
answer
intermediate filaments
question
Gap junctions function
answer
channel proteins that permit intercellular electrical/chemical communication
question
Gap junctions structural components
answer
connexons
question
Hemidesmosomes function
answer
connect keratin to basement membrane
question
Integrins function
answer
membrane proteins that bind collagen, laminin, maintain integrity of basement membrane
question
if autoantibodies target desmosomes, what disease does this cause?
answer
pemphigus vulgaris
question
if autoantibodies target hemidesmosomes, what disease does this cause?
answer
bullous pemphigoid
question
describe the lesion
answer
macule
question
describe the lesion
answer
patch
question
describe the lesion
answer
papule
question
describe the lesion
answer
plaque
question
describe the lesion
answer
vesicle
question
describe the lesion
answer
bulla
question
describe the lesion
answer
pustule
question
describe the lesion
answer
wheal
question
describe the lesion
answer
scale
question
describe the lesion
answer
crust
question
identify the pathology
answer
labial macule
question
identify the pathology
answer
congenital nevus
question
identify the pathology
answer
nevus
question
identify the pathology
answer
Psoriasis
question
identify the pathology
answer
shingles
question
identify the pathology
answer
bullous pemphigoid
question
identify the pathology
answer
pustular psoriasis
question
identify the pathology
answer
urticaria
question
identify the pathology
answer
squamous cell carcinoma
question
identify the pathology
answer
impetigo
question
Hyperkeratosis definition (dermatology)
answer
increased thickness of stratum corneum
question
parakeratosis definition (dermatology)
answer
hyperkeratosis w/ retention of nuclei in stratum corneum
question
Hypergranulosis definition (dermatology)
answer
increased stratum granulosum thickness
question
Spongiosis definition (dermatology)
answer
epidermal accumulation of edematous fluid in intercellular spaces
question
Acantholysis definition (dermatology)
answer
epidermal cell separation
question
Acanthosis definition (dermatology)
answer
epidermal hyperplasia, increased stratum spinosum thickness
question
What diseases involve hyperkeratotic lesions? (dermatology)
answer
psoriasis, calluses
question
What diseases involve parakeratotic lesions? (dermatology)
answer
psoriasis
question
What diseases involve hypergranulolitic lesions? (dermatology)
answer
lichen planus
question
What diseases involve spongiotic lesions? (dermatology)
answer
eczematous dermatitis
question
What diseases involve acantholytic lesions? (dermatology)
answer
pempigus vulgaris
question
What diseases involve acanthotic lesions? (dermatology)
answer
acanthosis nigricans
question
Albinism pathogenesis
answer
tyrosinase deficiency causes decreased melanin production, normal number of melanocytes
question
Albinism complications
answer
skin cancer
question
Melasma (cholasma) pathogenesis
answer
hyperpigmentation associated with pregnancy, OCPs
question
Vitiligo pathogenesis
answer
autoimmune melanocyte destruction causes irregular areas of complete depigmentation
question
identify the pathology
answer
albinism
question
identify the pathology
answer
melasma
question
identify the pathology
answer
vitiligo
question
Acne vulgaris pathogenesis
answer
increased sebum, androgens causes abnormal keratinocyte desquamation, infection causes inflammation
question
Atopic dermatitis clinical presentation
answer
pruritic eruption, typically on flexor creases, face in infancy
question
Atopic dermatitis lab findings
answer
increased IgE
question
Atopic dermatitis disease associations
answer
asthma, allergies
question
Allergic contact dermatitis pathogenesis
answer
type IV hypersensitivity, occurs at site of contact
question
Melanocytic nevus alternate name
answer
mole
question
Melanocytic nevus pathogenesis
answer
benign melanocyte tumor, can transform to atypical mole, melanoma
question
Psoriasis clinical presentation
answer
papules/plaques with silver scale, common on knees, elbows, Auspitz sign
question
Psoriasis histologic morphology
answer
acanthosis w/ parakeratotic scaling, munro microabscesses, large stratum spinosum, small stratum granulosum
question
Psoriasis disease associations
answer
nail pitting, psoriatic arthritis
question
Rosacea pathogenesis
answer
inflammation facial skin disorder
question
Rosacea clinical presentation
answer
erythematous papules/pustules, no comedones, possible facial flushing with external stimuli
question
Seborrheic keratosis pathogenesis
answer
flat greasy pigmented squamous epithelial proliferation, keratin filled cysts, benign neoplasm
question
Leser-Trelat sign
answer
sudden appearance of multiple seborrheic keratoses, indicates underlying malignancy
question
Verrucae pathogenesis
answer
warts due to HPV
question
Verrucae clinical presentation
answer
soft, tan, cauliflower liek papules
question
Verrucae histologic morphology
answer
epidermal hyperplasia, hyperkeratosis, koilocytosis
question
Urticaria pathogenesis
answer
pruritic wheals due to mast cell degranulation
question
Urticaria histologic morphology
answer
superficial dermal edema, lymphatic channel dilation
question
identify the pathology
answer
Acne vulgaris
question
identify the pathology
answer
atopic dermatitis
question
identify the pathology
answer
atopic dermatitis
question
identify the pathology
answer
allergic contact dermatitis
question
identify the pathology
answer
allergic contact dermatitis
question
identify the pathology
answer
papular intradermal nevus
question
identify the pathology
answer
junctional nevus
question
Identify the clinical finding and associated pathology
answer
papules/plaques w/ silver scale, psoriasis
question
Identify the clinical finding and associated pathology
answer
auspitz sign, psoriasis
question
identiy the pathology
answer
rosacea
question
Identify the clinical finding and associated pathology
answer
horn cyst, seborrheic keratosis
question
identify the pathology
answer
leser-trelat sign
question
identify the pathology
answer
verrucae
question
Identify the clinical finding and associated pathology
answer
condyloma acuminatum, HPV
question
identify he pathology
answer
urticaria
question
identify the pathology
answer
bacillary angiomatosis
question
identify the pathology
answer
cherry angioma
question
identify the pathology
answer
cystic hygroma
question
identify the pathology
answer
glomus tumur
question
identify the pathology
answer
pyogenic granuloma
question
identify the pathology
answer
strawberry hemangioma
question
Angiosarcoma typical distribution
answer
head, neck, breast
question
Angiosarcoma risk factors
answer
elderly, sun exposure, radaiation, chronic postmastectomy lymphedema
question
Hepatic Angiosarcoma risk factors
answer
vinyl chloride, aresenic
question
Angiosarcoma typical behavior
answer
very aggressive, difficult to resect
question
Bacillary angiomatosis clinical presentation
answer
benign capillary skin papules
question
Bacillary angiomatosis causative agent
answer
B. henselae, only in AIDS
question
Bacillary angiomatosis histologic morphology
answer
neutrophilic infiltrate
question
Cherry hemangioma pathogenesis
answer
benign capillary hemangioma, does not regress
question
cystic hygroma pathogenesis
answer
cavernous lymphangioma of neck
question
cystic hygroma disease associations
answer
turner syndrome
question
glomus tumor clinical presentation
answer
benign painful, red blue tumor, commonly under fingernails
question
glomus tumor pathogenesis
answer
tumor of modified SMCs of thermoregulatory glomus body
question
Kaposi sarcoma causative agent
answer
HHV8 in HIV+ patients
question
Kaposi sarcoma pathogenesis
answer
endothelial malignancy of skin, mouth, GI, respiratory tract
question
Kaposi sarcoma histologic morphology
answer
lymphocytic infiltrate
question
Pyogenic granuloma pathogenesis
answer
polypoid lobulated capillary hemangioma, can ulcerate/bleed
question
Pyogenic granuloma risk factors
answer
trauma, pregnancy
question
Strawberry hemangioma pathogenesis
answer
benign capillary hemangioma of infancy
question
Strawberry hemangioma clinical course/behavior
answer
appears in first few weeks of life, grows rapidly, regresses spontaneously
question
Impetigo pathogenesis
answer
strep/staph superficial skin infection, highly contageous
question
Impetigo clinical presentation
answer
honey colored crust
question
Bullous impetigo characteristics
answer
similar to Impetigo + bullae, due to S. aureus
question
Erysipelas pathogenesis
answer
upper dermal/superficial lymphatics infection due to S. pyogenes
question
Erysipelas clinical presentation
answer
well defined demarcation between infected/normal skin
question
Cellulitis pathogenesis
answer
acute painful spreading infection of deeper dermis/SQ, due to strep/staph
question
Cellulitis risk factors
answer
skin break/trauma
question
Abscess pathogenesis
answer
collectin of walled of infection/pus within deeper skin layers
question
Abscess most common causative agent
answer
S. aureus
question
Necrotizing fasciitis pathogenesis
answer
deeper tissue injury causes S. pyogenes/anaerobic infection, produces bullae, purple color
question
Necrotizing fasciitis clinical presentation
answer
pain out of proportion to exam, crepitus due to gas production
question
Hairy leukoplakia clinical presentation
answer
irregular white painless plaques on lateral tongue, cannot be scraped off
question
Hairy leukoplakia pathogenesis
answer
EBV mediated in immunosuppressed patients
question
identify the pathology
answer
impetigo
question
identify the pathology
answer
bullous impetigo
question
identify the pathology
answer
erysipelas
question
identify the pathology
answer
cellulitis
question
identify the pathology
answer
abscess
question
identify the pathology
answer
necrotizing fasciitis
question
identify the clinical finding and associated pathology
answer
Nikolsky sign, staphylococcal scalded skin syndrome
question
identify the clinical finding and associated pathology
answer
herpetic whitlow, HSV
question
identify the pathology
answer
molluscum contagiosum
question
identify the pathology
answer
hairy leukoplakia
question
Staphylococcal scalded skin syndrome pathogenesis
answer
S. aureus exotoxin destroys keratinocyte attachment, causes skin sloughing
question
Staphylococcal scalded skin syndrome clinical presentation
answer
fever, generalized erythematous rash, upper epidermal sloughing, no scarring, + nikolsky sign
question
Staphylococcal scalded skin syndrome risk factors
answer
neonates, children, renal insufficiency
question
Pemphigus vulgaris pathogenesis
answer
type II hypersensitivity: anti-desmoglein IgG destroys intracellular desmosomes, acantholysis
question
Pemphigus vulgaris
answer
flaccid intraepidermal bullae, + nikolsky sign, may involve oral mucosa
question
Nikolsky sign
answer
epidermis separates upon manual skin stroking
question
Pemphigus vulgaris immunofluorescence findings
answer
antibodies around epidermal cells in reticular pattern
question
Bullous pemphigoid pathogenesis
answer
type II hypersensitivity: anti-hemidesmosome IgG detaches epidermis from basement membrane
question
Bullous pemphigoid clinical presentation
answer
tense blisters w/ eosinphils, spares oral mucosa
question
Bullous pemphigoid immunosluorescence findings
answer
linear pattern of antibodies at epidermal-dermal junction
question
dermatitis herpetiformis clinical presentation
answer
pruritic papules, vesicles, bullae
question
dermatitis herpetiformis disease associations
answer
celiac disease
question
dermatitis herpetiformis immunofluorescence findings
answer
IgA deposits at tips of dermal papillae
question
dermatitis herpetiformis treatment
answer
dapsone, gluten free diet
question
Erythema multiforme disease associations
answer
infections, (M. pneumoniae, HSV) drugs (sulfa, beta lactam, phenytoin), cancer, autoimmunity
question
Erythema multiforme clinical presentation
answer
multiple types of lesions
question
Stevens-Johnson syndrome clinical presentation (early)
answer
fever, bullae formation, necrosis, skin sloughing, involves >2 mucous membranes
question
Stevens-Johnson syndrome clinical presentation (late)
answer
targetoid skin lesions
question
Stevens-Johnson syndrome typical etiology
answer
drug adverse effect
question
toxic epidermal necrolysis
answer
more severe form of SJS
question
identify the clinical finding and associated pathology
answer
flaccid bullae, pemphigus vulgaris
question
identify the clinical finding and associated pathology
answer
reticular pattern, pemphigus vulgaris
question
identify the clinical finding and associated pathology
answer
tense blisters, bullous pemphigoid
question
identify the clinical finding and associated pathology
answer
linear pattern, bullous pemphigoid
question
identify the pathology
answer
dermatitis herpetiformis
question
identify the clinical finding and associated pathology
answer
targetoid lesions, erythema multiforme
question
identify the pathology
answer
SJS involving mucous membranes
question
identify the pathology
answer
SJS involving mucous membranes
question
identify the pathology
answer
toxic epidermal necrolysis/SJS
question
identify the pathology
answer
toxic epidermal necrolysis/SJS
question
acanthosis nigricans pathogenesis
answer
epidermal hyperplasia causes symmetric skin thickening w/ hyperpigmentation
question
acanthosis nigricans typical distribution
answer
axilla, neck
question
acanthosis nigricans disease associations
answer
insulin resistance, visceral malignancy
question
Actinic keratosis pathogenesis
answer
premalignant lesions due to sun exposure
question
Actinic keratosis clinical presentation
answer
small rough erythematous/brown papules/plaques
question
Actinic keratosis complications
answer
squamous cell carcinoma risk
question
Erythema nodosum pathogenesis
answer
painful raised inflammatory lesions of SQ fat
question
Erythema nodosum disease associations
answer
Sarcoidosis, Cocci, histoplasma, TB, strep, leprosy, IBD
question
Lichen planus clinical presentation
answer
pruritic, purple, polygonal, planar papules
question
Lichen planus histologic morphology
answer
sawtooth lymphcytic infiltrate at dermal-epidermal junction
question
Lichen planus disease associations
answer
HCV
question
Pityriasis rosea clinical presentation
answer
herald patch followed by other scaly erythematous plaques, christmas tree distribution
question
Pityriasis rosea typical distrubiont
answer
trunk
question
Pityriasis rosea clinical course
answer
resolves in 6-8 weeks spontaneously
question
Sunburn pathogenesis
answer
acute cutaneous inflammatory reaction due to excess UV light
question
Sunburn complications
answer
skin cancer, impetigo
question
identify the pathology
answer
acanthosis nigricans
question
identify the pathology
answer
acanthosis nigricans
question
identify the pathology
answer
actinic keratosis
question
identify the pathology
answer
actinic keratosis
question
identify the pathology
answer
erythema nodosum
question
identify the pathology
answer
erythema nodosum
question
identify the pathology
answer
lichen planus
question
identify the pathology
answer
lichen planus
question
identify the pathology
answer
pityriasis rosacea
question
identify the pathology
answer
pityriasis rosacea
question
basal cell carcinoma typical distribution
answer
sun exposed areas, esp. face
question
basal cell carcinoma typical behavior
answer
locally invasive, rarely metastasizes
question
basal cell carcinoma clinical presentation
answer
waxy pink pearly nodules with telangiectasias, rolled borders, central crust/ulceration
question
basal cell carcinoma histologic morphology
answer
palisading nuclei
question
Squamous cell carcinoma risk factors
answer
excessive sunlight exposure, immunosuppression, chronicaly draining sinuses, arsenic exposure
question
Squamous cell carcinoma typical distribution
answer
face, lower lip, ears, hands
question
Squamous cell carcinoma typical behavior
answer
locally invasive, may spread to lymph nodes, rarely metastasizes
question
Squamous cell carcinoma clinical presentation
answer
ulcerative red lesions w/ scale
question
Squamous cell carcinoma histologic morphology
answer
keratin pearls
question
Keratoacanthoma characteristics
answer
squamous cell carcinoma variant, grows rapidly, then regresses spontaneously
question
Melanoma immunostaining characteristics
answer
S100
question
Melanoma risk factors
answer
sunlight, dysplastic nevi, light skin
question
Melanoma molecular pathogenesis
answer
BRAF mutation
question
Melanoma treatment
answer
excision, BRAF kinase inhibitors (vemurafenib)
question
identify the pathology
answer
basal cell carcinoma
question
identify the pathology
answer
ulcerated basal cell carcinoma
question
identify the pathology
answer
superficial BCC
question
identify the pathology
answer
BCC
question
identify the pathology
answer
squamous cell carcinoma
question
identify the pathology
answer
squamous cell carcinoma
question
identify the clinical finding and associated pathology
answer
squamous pearl, squamous cell carcinoma
question
identify the pathology
answer
keratoacanthoma
question
identify the pathology
answer
superficial spreading melanoma
question
identify the pathology
answer
nodular melanoma
question
identify the pathology
answer
lentigo maligna (melanoma)
question
identify the pathology
answer
acral lentiginous melanoma
