40: Myopathies - Kanis

Question 1

when is duchenne’s muscular dystrophy apparent/diagnosed?

Answer 1

3-5 yo
present at birth though
frequent falls and can’t keep us with friends

becker muscular dystrophy is seen age 5-15 (walk beyond 15 yr)

Question 2

gowers sign =

Answer 2

pt uses hands to climb up himself when getting up from floor

= duchenne’s muscular dystrophy

Question 3

definitive diagnosis duchenne’s muscular dystophy

Answer 3

dystrophin is absent in a biopsy or with a mutation analysis of leukocytes

Question 4

dermatomyositis and polymyositis affect the

Answer 4

proximal muscles.

chair, climbing steps, lifting, combing hair, stepping on curb
facial and ocular not affected

dermatomyositis present earlier because of rash

Question 5

dermatomyositis needs what screening?

Answer 5

*** important to get all screening exams for cancer

increased association with malignancy

Question 6

worst statin

Answer 6

simvastatin

increased risk myalgias
CK will be elevated

best thing to do: stop simvastatin and follow pt

Question 7

statins and fibrates –>

Answer 7

myalgia, malaise, and muscle tenderness

may be related to exercise

muscle necrosis

severe rxns have rhabdomyolysis and myoglobinuria

elevated CK is indication of toxicity

stop the drug