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First Aid 2012 pp404-428
89
Medical
Graduate
02/07/2013

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Term
epidermis layers
Definition
Californians Like Girls in String Bikinis
Corneum
Lucidum
Granulosum -- free nerve endings
Spinosum -- Langerhans
Basalis -- melanocytes, Merkel cells
Term
epidermal appendages
Definition
sebacous -- holocrine!!
eccrine -- sweat
apocrine -- odor (axilla, groin, areaolae)
Term
composition of...
-- zona occludens
-- zona adherens
-- macula adherens
-- gap junction
Definition
tight junction -- claudins, occludins
intermediate junction -- E-adherins, actin
desmosome -- cadherins, intermediate filaments (i.e. keratin), desmoplakin
gap -- connexon
Term
things in basement membrane
Definition
laminin, fibronectin, collagen
Term
unhappy triad
Definition
MCL, ACL, medial meniscus
Term
rotator cuff
Definition
S A ; suprascap n.
I E ; suprascap n
T E and adducts; axillary n
S I and adducts; subscapular n
Term
wrist bones
Definition
Some Lovers Try Positions That They Can't Handle (thumb to pinky; up to thumb to pinky)

Scaphoid
Lunate
T
Pisiform
T
T
Capitate
Hamate
Term
nursemaid's elbow -- what is it, what's injured
Definition
radial head subluxation
annular ligament is torn and displaced
Term
middle finger dermatome
Definition
C7
Term
radial pulse disappears when moving head toward one side
Definition
thoracic outlet syndrome (IPSI)
Term
thenar and hypothenar muscles
Definition
OAF
opposition
aBduction
flexion
Term
anterior hip dislocation
Definition
obturator n (L2-4)
thigh adduction
medial thigh sensation
Term
pelvic fracture
Definition
femoral (L2-4)
thigh flexion, leg extension
anterior thigh and medial leg (saphenous n.)
Term
trauma to lateral leg or fibula neck
Definition
common peroneal (L4-S2)
PED -- eversion (superficial), dorsiflexion (deep)
anterolateral leg and dorsal/medial foot (1st web space -- deep)
Term
knee trauma
Definition
tibial n (L4-S2)
TIP -- inversion, plantarflexion
sole of foot
Term
posterior hip dislocation or polio
Definition
superior gluteal (L4-S1) -- medius, minimus
thigh abduction (Trendelenburg sign -- CONTRA hip drops when standing on lesioned leg)
Term
posterior hip dislocation
Definition
inferior gluteal (L5-S2) -- maximus
thigh extension, lateral rotation
Term
where psoas starts from
Definition
on vertebrae!!
Term
dihydropyridine receptor
Definition
on cell membrane, voltage-gated
Term
ryanodine receptor
Definition
on SR, connected to dihydropyridine receptor
Term
bands on muscle fibers
Definition
A band -- dArk -- myosin + actin
I band -- lIght -- actin only
H band -- myosin only
M line -- myosin attaches
Z line -- actin attaches
Term
skeletal muscle things
Definition
Ca binds troponin C
troponin C moves tropomyosin off actin
myosin can bind actin
kick out Pi = power stroke
bind ATP = myosin let's go
Term
smooth muscle things
Definition
Ca binds calmodulin
calmodlin activates MLCK
phosphorylated myosin CONTRACTS

NO --> cGMP --> MLC phosphatase --> removes phosphate group from MLC --> relaxes
Term
muscle fiber types
Definition
"one slow red ox"
type 1 -- slow twitch, red fiber (lots of mitochondria), postural muscles
Term
median nerve travels between
Definition
flexor digitorum superficialis and profundus
Term
which artery travels with radial n?
Definition
deep brachial artery
Term
achondroplasia mutation
Definition
constitutive FGFR3 activation inhibits chondrocyte prolif!!
Term
trabecular bone loss
Definition
osteoporosis -- increased bone resorption
type I - postmenopausal, prolactinoma --> low estrogen
type II - senile
normal labs
Term
marrow filled by primary spongiosa, Erlenmeyer flask bones
Definition
osteopetrosis -- decreased bone resorption
nomal labs
Term
excessive osteoid, widened osteoid seams
Definition
osteomalacia/rickets -- Vit D def --> defective mineralization/calcification
low Vit D --> low Ca/PO4 --> high PTH
Term
mosaic bone pattern, "cement lines", chalk-stick fractures
Definition
Paget's -- increased osteoclast activity --> increased osteoblast activity
high alk phos
osteogenic sarcoma!!
Term
brown tumors
Definition
osteitis firosa cystica -- high PTH --> cystic bone spaced filled with brown fibrous tissue
high PTH --> high Ca/low PO4
Term
McCune-Albright
Definition
precocious puberty
polyostotic fibrous dysplasia -- bone replaced fibroblasts, collagen, irregular bony trabeculae
pigmentation (cafe au lait)
Term
#1 determinant of bone density
Definition
genetics!!
Term
marker of osteoblast activity
Definition
alk phos!!
Term
TRAP+, multinucleate cell
Definition
osteoclast!!
Term
osteoclast activation
Definition
RANKL, M-CSF from osteoblast
OPG is RANKL decoy!!
Term
"double bubble" or "soap bubble"
Definition
osteoclastoma = giant cell tumor
benign
epiphyseal
spindle shaped cells, giant cells!
Term
outgrowth of bone + cartilage cap
Definition
osteochondroma = exostosis
benign
metaphysis
Term
Codman's triangle, sunburst pattern
Definition
osteosarcoma = osteogenic sarcoma
malignant
metaphysis
Paget's, infarcts, radiation, familial retinoblastoma -- most common primary malignant bone tumor!!
Term
onion skin
Definition
Ewing's sarcoma
malignant
diaphysis
anaplastic small blue cell (chemo!)
t(11;22)
Term
expansile glistening mass in medullary cavity
Definition
chondrosarcoma
malignant cartilaginous tumor
diaphysis
Term
Heberden's nodes vs. Bouchard's nodes
Definition
Heberden's -- DIP
Bouchard's -- PIP
Term
which side more osteoarthritis?
Definition
medial side!!
Term
random hydroxychloroquine side effect
Definition
retinal damage!!
Term
Baker's cyst
Definition
RA, behind knee
can mimic DVT?!
Term
Boutonniere deformity vs. Swan-neck deformity
Definition
Boutonniere -- PIP up!! (tented finger)
Swan-neck -- PIP down (straight-ish finger)
Term
RA antibodies; what type of hypersensitivity?
Definition
RF
anti-CCP!!
type III hypersensitivity
Term
Sjogren's vs. sicca syndrome
Definition
BOTH -- dry eyes, dry mouth
Sjogren's -- arthritis
Sicca -- dry nose/vaginal, chronic bronchitis, reflux esophagitis, NO arthritis!!
Term
associated with Sjogrens
Definition
parotid enlargement
B-cell lymphoma
Term
gout
Definition
monosodium urate -- needle-shaped, negatively birefringent -- yellow, parallel
von Gierke's disease (lactic acid competes for renal excretion!!)
after large meal or alcohol (alcohol metabolites compete for renal excretion!!)
Term
pseudogout
Definition
calcium pyrophosphate -- rhomboid, positively birefringent
Term
positive vs. negatively birefringent
Definition
positive -- yellow perpendicular, blue parallel
negative -- blue perpendicular, yellow parallel
Term
septic arthritis
Definition
Staph aureus, Strep, Neisseria gonorrhea (STD = Synovitis, Tenosynovitis, Dermatitis = pustules)
Term
sero-negative spondyloarthopathies
Definition
PAIR
Psoriatic -- dactylitis ("sausage fingers"), "pencil-in-cup"
Ankylosing spondylitis -- bamboo spine; assoc with uveitis, aortic regurg 2/2 ascending aortitis!!, peripheral enthesopathies (can ffect ostovertebral/costosternal junctions --> hypoventilation --> measure CHEST EXPANSION!!)
IBD
Reactive arthritis -- post-GI or chlamydia
Term
random SLE stuff
Definition
F, fatigue, weight loss
hilar adenopathy
Raynaud's
Term
random sarcoidosis stuff
Definition
erythema nodosum, Bell's palsy
Schaumann (Ca and protein inclusions in giant cells) and asteroid (fireworks!) bodies
uveoparotits
hypercalcemia 2/2 activated macrophages
Term
polymyalgia rheumatic
Definition
pain and stiffness in shoulders/hips
NO weakness, normal CK
temporal arteritis
Term
polymyositis
Definition
symmetric, proximal weakness
CD8+ T cell induced injury to myofibers!
high CK, aldolase
Term
dermatomyositis
Definition
Gottron papules (MCPs, IPs -- looks psoriasis-like)
perifascicular atrophy
increased malignancy risk
Term
curare, hemicholinium
Definition
curare -- competes with ACh
hemicholinium -- blocks choline reuptake --> ACh depletion
Term
diffuse scleroderma vs. CREST
Definition
diffuse -- rapid progression, early visceral involvement
CREST -- more benign
Term
parakeratosis
acanthosis
spongiosis
Definition
parakeratosis -- hyperkeratosis with retention of nuclei
acanthosis -- epidermal hyperplasia (of spinosum)
spongiosis -- epidermal accum of edematous fluid in intercellular spaces
Term
verrucae
Definition
wart
vulgaris = on hands
Term
condyloma acuminatum
Definition
genital warts
Term
ephelis
Definition
freckle -- increased melanin pigment
Term
allergic dermatitis
Definition
type IV hypersenstivity
spongiosis histology (like early eczema!!)
Term
psoriasis
Definition
acanthosis, parakeratosis, decreased statum granulosum
Auspitz sign -- bleeding spots when scales scraped off
Munro abscesses -- stratum corneum
Term
seborrheic keratosis
Definition
pigmented epithelial prolif with keratin-filled cysts (horn cysts)
"pasted on"
Leser-Trelat -- a bunch suddenly = malignancy!!
Term
albinism vs. vitiligo
Definition
albinism -- decreased melanin production
vitiligo -- decreased melanocytes (the actual cells go away!!)
Term
melasma = cholasma
Definition
hyperpig associated with pregnancy or OCPs (mask of pregnancy!!)
Term
where is the problem?
impetigo
cellulitis
necrotizing fasciitis
SSSS
Definition
impetigo -- superficial
cellulitis -- dermis, SQ tissue
necrotizing fasciits -- deep!!
SSSS -- stratum granulosum!!!
Term
pemphigus vulgaris vs. bullous pemphigoid
Definition
PV -- desmisomes, intraepidermial bullae, skin AND mucoa, + Nikolsky's sign

BP -- hemidesmisomes, subepithelial bullae, skin ONLY, - Nikolsky's sign, eosinophils!!
Term
dermatitis herpetiformis
Definition
pruritis papules/vesicles on extensor surfaces; IgA deposits and microabscesses at dermal papillae
Term
erythema multiforme
Definition
infection (Mycoplasma pneumo, HSV), drugs (sulfa, beta-lactams, phenytoin), cancer, auto-immune
target cells; multiple forms
Term
lichen planus
Definition
Pruritis
Purple
Polygonal
Papules
sawtooth infiltrate of lymphs
hep C
Term
actinic keratosis
Definition
small, rough, papules with central scale
sandpaper feel
cutaneous honr
Term
random thing associated with acanthosis nigricans
Definition
visceral malignancy!!
Term
erythema nodosum
Definition
inflam lesions of SQ fat! on shins
fungi (coccidioidomycosis, histoplasmosis), mycobacteria (TB, leprosy), Strep, sarcoidosis
Term
keratoacanthoma
Definition
squamous cell carcinoma variant that grows rapidly and regresses spontaneously!!
Term
basal cell histology
Definition
dark cells with palisading nuclei
Term
melanoma genetics
Definition
BRAF mutation (oncogene)
Term
knee bursas
Definition
prepatella -- "housemaid's knee"
anserine -- medial knee; atheletes, large body habitus
popliteal/gastrocnemius -- Baker's cysts
Term
site of osteomyelitis
Definition
metaphysis
Term
butt shots -- where to give, where not to give and why?!
Definition
good -- superolateral
superomedial --> superior gluteal n. (Trendelenburg sign)
inferomedial --> sciatic n.
Term
most rapid and complete relief of RA symtpoms
Definition
steroids!
Term
urticaria
Definition
superficial dermal edema, lymphatic dilation, NO epidermal changes
Term
femoral neck fracture
Definition
medial circumflex artery damage --> avascular necrosis (provides majority of blood to femoral head and neck)
Term
subperiosteal thinning of bones
Definition
renal osteodystrophy
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