USMLE 1 Path Muscle/Bone
Terms
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Dx:
autosomal dominant trait leading to the failure of longitudinal bone growth, causing short limbs - Achondroplasia
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Dx:
Pannus formation in joints - Rheumatoid Arthritis
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Dx:
increased bone resorption due to decreased estrogen levels -
Osteoporosis (type 1)
(type 2 is men and women >70) - (2) common fractures due to Osteoporosis
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Vertebral crush fractures
Collies distal Radius Fx -
Definition:
failure of normal bone resorption leading to thick, dense bones due to abnormal function of Osteoclasts; no labs elevated; "marble bone Dz" - OsteoPETrosis
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Definition:
increase in oseteoblastic and osteoclastic activity; all labs normal except great increase in Alk Phos - Padget Dz of the Bone
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Dx:
bone replaced w/ fibroblasts and collagen (PFD) in unilateral bones, precocious puberty, unilateral pigmented skin - Albright's syndrome
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Definition:
pain and stiffness in shoulders and hips, often w/ fever and weight loss in pt >50yo
what is it assoc w/? -
Polymyalgia rheumatica
assoc w: Temporal (giant cell) arteritis - what joint problem can be caused by G6PD deficiency?
- Gout
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Dx:
painful MTP joint, formations on external ear or achilles tendon
test? -
Gout
(Tophus formations are on ear and achilles)
Test: joint aspiration
(Needle-shaped Negatively birefringement) -
Dx:
calcium crystals in the knee
test? -
Pseudogout
Test: joint aspiration
(Basophilic, rhomboid, Positively Birefringement) -
Dx:
Gammaglobinemia, RA, ACE increase, Interstitial lung fibrosis, Noncaseating granulomas -
Sarcoidosis
"GRAIN" -
(2) types of Seronegative spondyloarthropathies
(arthritis w/o rheumatoid factor) -
Ankylosing Spondylitis
Reiter's syndrome -
Dx:
chronic inflammatory dz of spine and sacroiliac joints, uveitis and aortic regurg - Ankylosing Spondylitis
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Dx:
Urethritis, conjunctivitis and anterior uveitis and arthritis -
Reiter's syndrome
(Can't see, can't pee, can't climb a tree) -
Dx:
an acquired loss of melanocytes in descrete areas of skin that appear as depigmented white patches - Vitiligo
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Definition:
epidermal hyperplasia and hyperpigmentation most often in flexural areas and a marker of visceral malignancy - Acanthosis Nigricans
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Dx:
port-wine stain on the face, ipsilateral glaucoma, vascular lesions of ocular tissue, extensive hemangiomatous involvement of meninges - Sturge-Weber syndrome
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Dx:
pruitic eruption, commonly on the flexor surfaces
(2 names) -
Atopic Dermatitis
(Eczema) -
Dx:
Epidermal hyperplasia w/ parakeratotic scaling especially on knees and elbows
what layer of skin is increased?
Decreased? -
Psoriasis
Inc Spinosum
Dec Granulosum -
Definition:
Pruritic papules and vesicles associated w/ Celiac sprue - Dermatitis Herpetiformis
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Dx:
Pruitic, purple, polygonal papules; infiltrate of lymphocytes at the dermalepidermal junction -
Lichen Planus
[Lymphocytes = Lichen] -
Definition:
assoc w/ infections, drugs, CA and autoimmune Dz; presents w/multiple types of lesions including macules, papules, vesicles and Target lesions - Erythema Multiforme
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Dx:
erythema multiforme, high fever, bulla formation and necrosis, ulceration of skin; high mortality rate - Stevens-Johnson syndrome
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Dx:
common benign flat pigmented squamous epithelial proliferation of keratin-filled (horn) cysts that look pasted-on - Seborrheic Keratosis
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Definition:
subepidermal blistering w/ characteristic inflammatory infiltrate of eosinophils in the surrounding dermis;
auto Ab against epidermal BM - Bullous Pemphigoid
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Dx:
Blistering of oral mucosa with extensive skin involvement following; breakdown of cell-to-cell junctions w/ sparing of basement layer; auto Ab against epidermal cell surface - Pemphigus Vulgaris
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Dx:
skin cancer of face and hands w/ keratin "pearls" - Squamous cell CA
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Dx:
skin cancer in sun-exposed areas of body; pearly papules w/ "palisading" nuclei - Basal cell CA
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Dx:
skin CA that can metastasize
what characteristic correlates to increased risk of metastasis? -
Melanoma
(Inc Depth of tumor = Inc Mets) - what is common w/ all primary metatastic bone tumors?
- they are all "Sarcomas"
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Dx:
epiphyseal tumor at end of long bone (usu at knee) w/ spindle-shaped cells and "soap bubble" or "double bubble" -
Giant cell Tumor
(MC female bone tumor) -
Dx:
bone growth covered by a cap of cartilage, usu in men < 25yo - Osteochondroma
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Dx:
benign neoplasm of intermedullary bone usu in fingers and toes and w/o pain - Endochondroma
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Dx:
replacement of intermedullary bone w/ fibrous tissue; "ground-glass" appearance on x-ray; "Chinese character" w/o osteoblasts - Fibrous Displasia
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Definition;
Giant cell-like bone tumor of metaphysis or vertebrae; pain and swelling; hemorrhagic cysts w/ giant cells - Aneurysmal Bone Cyst
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Dx:
males < 25yo w/ central "nidus" of osteoid surrounded by a shell; painful (wake from sleep); responsive to aspirin - Osteoid Osteoma
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Dx:
boys < 15yo w/ tumor of pelvis or shaft of long bones; small round blue cell tumor; PAS+; "Onionskin" look to bone
what translocation? -
Ewing Sarcoma
[eWINGS and Onion rings]
t(11;22) -
Dx:
bone tumor w/ osteoid spindle cells, usu the knee; painful and aggressive; Inc Alk Phos; elevation of periosteum
(Codman's triangle) -
Osteosarcoma
(MC primary bone malignancy) -
Dx:
malignant cartilaginous tumor in the central skeleton, painful and slow-growing; bluish-white appearance w/ sectioning - Chondrosarcoma
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Dx:
weakness in proximal muscles of extremities, later compensatory hypertrophy of distal site (calf) and eventual pseudohypertrophy; Inc serum CK; death from weak resp muscles
genetics? -
Duchenne Muscular Dystrophy
(frameshift deletion of Dystrophin) -
Definition:
similar to DMD, but less severe; segmental deletions in Dystrophin - Becker muscular dystrophy
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Dx:
Inability to relax muscles once contracted, weakness, cataracts and testicular atrophy -
Myotonic Dystrophy
(CTG repeats - Auto Dominant) -
Dx:
weakness of extraocular and facial muscles, muscle weakness w/ use and recovery w/ rest, difficult chewing, swallowing, resp failure, more common in women -
Myasthenia Gravis
(Ab to ACh receptor) -
Definition:
paraneoplastic syndrome w/ clinical manifestations similar to those of myasthenia gravis -
Lambert-Eaton syndrome
(MC w/ Small cell CA of Lung) -
Dx:
pigeon breast, string-of-beads in costochondrial junction, depression along line of insertion of diaphragm to rib cage (Harrison groove), High-output Cardiac failure -
Rickets
(Vit D deficiency)