Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK Week 2 2017/18 > 7: Muscle disease > Flashcards

7: Muscle disease Flashcards

1
Q

What does myopathy mean?

A

Any pathology involving muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some symptoms of muscle disease?

A

Myalgia (muscle pain)

Muscle weakness (often described as tired, heavy)

Stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the generic name for inflammatory muscle disease?

A

Myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are two idiopathic inflammatory myopathies?

A

Polymyositis

Dermatomyositis (+ skin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Myositis is more common in (men / women).

A

women

as with all autoimmune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

People with myositis are at increased risk of ___.

A

malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can be seen under the microscope in someone with myositis?

A

Necrosis

Regeneration

Inflammatory cell infiltrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which muscles are commonly affected by myositis?

A

Shoulder muscles

Hip muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main symptom of myositis?

A

Muscle weakness

i.e difficulty performing everyday tasks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Myositis has an (acute / insidious) onset.

A

insidious

over a period of months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Is myositis symmetrical or asymmetrical?

A

Symmetrical

(Inclusion body myositis can be asymmetrical)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are typical skin features of dermatomyositis?

A

Gottron’s papules - violet patches over PIP and MCP joints

Heliotrope rash - characteristic rash around eyes

Shawl sign - rash on back, as if patient has been wrapped up in a blanket (made of acid???)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

10% of myositis patients also have lung disease - which type?

A

Interstitial lung disease

pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a GI symptom associated with myositis?

A

Dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which type of cardiac muscle may be affected by myositis?

What is this condition called?

A

Myocardium

Myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

People with muscle disease may have apparent (hypertrophy / atrophy).

A

atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is confrontational testing?

A

Patient attempts to resist your power, gives an indication of muscle strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is isotonic testing?

A

Gives indication of muscle stamina

e.g 30s sit to stand test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some blood tests which can be carried out to identify muscle disease?

A

Creatine kinase - released when muscles break down, first-line test

Inflammatory markers - CRP and ESR will be raised in inflammatory myopathies

U&Es - for other causes e.g hypocalcaemia, hyperkalaemia

Autoantibody tests - for anti Jo-1 antibody in particular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which non-specific autoantibody may be raised in inflammatory myositis?

A

ANA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a specific autoantibody for inflammatory myositis?

A

Anti-Jo-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which test involves putting two needles into muscle and passing a current through them to track action potentials?

A

Electromyography (EMG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the definitive test to diagnose inflammatory myositis?

A

Muscle biopsy - loads of signs of inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How is inflammatory myositis treated?

A

Steroids

Immunosuppressants as steroid-sparers: azathioprine, methotrexate, ciclosporin

be aware that methotrexate causes pneumonitis

Biologic agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Why are steroids started before immunosuppressants despite the fact that they may cause muscle pain as a side effect?

A

Immunosuppressants take 4-6 weeks to start working

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Apart from steroids and immunosuppressants, what else may be given to patients with severe inflammatory myositis?

A

IV immunoglobulin

Rituximab (inhibit B cells)

but expensive and lots of side effects so be careful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

(Poly)myositis and dermatomyositis are examples of ___ diseases.

A

autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Polymyositis and dermatomyositis affect (proximal / distal) muscles.

A

proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which myositis is more common in men, affects distal muscles and is often misdiagnosed as polymyositis?

A

Inclusion body myositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

If you’re treating a patient for inflammatory myositis and they aren’t responding to treatment, what should be considered?

A

Inclusion body myositis

31
Q

Is inclusion body myositis an autoimmune disease?

A

No

32
Q

Which class of drug may cause symptoms similar to myositis?

A

Statins

33
Q

Are polymyositis and polymyalgia the same thing?

A

Noooo

34
Q

Do people under the age of 50 get polymyalgia rheumatica?

A

No

35
Q

Which type of vasculitis is polymyalgia rheumatica associated with?

A

Giant cell arteritis

36
Q

Which muscles are affected by polymyalgia rheumatica?

A

Proximals - shoulders, hips

37
Q

Do people with polymyalgia rheumatica have muscle weakness?

A

No

38
Q

What are the symptoms of polymyalgia rheumatica?

A

Muscle PAIN

Muscle STIFFNESS

39
Q

Polymyalgia rheumatica has a (rapid / insidious) onset.

A

rapid onset - weeks

40
Q

People with polymyalgia rheumatica often feel quite unwell systemically - what symptoms may they have?

A

Fatigue

Anorexia

Weight loss

Fever

41
Q

What does a muscle biopsy of someone with polymyalgia rheumatica look like?

A

Normal

42
Q

What is vasculitis?

A

Inflammation of endothelium

43
Q

Which artery is affected by giant cell arteritis?

Which nerve does it supply?

A

Temporal artery

Optic nerve

44
Q

Which symptoms are associated with giant cell arteritis?

A

Pain, tenderness in the temporal region

Achey scalp

Jaw claudication

45
Q

Why do people with giant cell arteritis get jaw claudication?

A

Increased oxygen demand of mastication muscles

but vasculitis reduces blood flow

46
Q

People with giant cell arteritis often experience visual ___.

A

loss

47
Q

Why must visual loss associated with giant cell arteritis be treated seriously?

A

Permanent blindness may result

48
Q

In giant cell arteritis, the temporal arteries may become ___ and (palpable / unpalpable).

A

unpalpable

49
Q

How is polymyalgia rheumatica diagnosed?

A

Can only be diagnosed clinically

+/- Raised inflammatory markers

+/- Apparent giant cell arteritis

50
Q

How is polymyalgia rheumatica treated?

A

Steroids

51
Q

How long does polymyalgia rheumatica tend to last?

A

18-20 months

52
Q

The steroid dose for polymyalgia rheumatica is gradually (increased / reduced).

A

reduced

53
Q

Polymyalgia rheumatica shows a ___ response to steroids.

A

dramatic

54
Q

What is a very common non-inflammatory myopathy?

A

Fibromyalgia

55
Q

What is the prevalence of fibromyalgia?

A

2-5%

56
Q

Fibromyalgia is more common in (men / women).

A

women

57
Q

What may trigger fibromyalgia?

A

Emotional or physical stress

58
Q

Fibromyalgia is sort of cyclical because it is associated with a lot of other illness. What are some examples?

A

Depression

IBS

leading to poor sleep patterns and stress, fibromyalgia…

59
Q

What are the symptoms of fibromyalgia?

A

Myalgia - particularly neck, shoulders, hips

Pins and needles

Headaches

“Brain fog” - poor concentration and memory

60
Q

How do fibromyalgia patients describe their pain?

A

Diffuse

Exacerbated by exertion, fatigue, stress

61
Q

Fibromyalgia often ___ sleep.

A

disturbs

described as ‘unrefreshing’

62
Q

Similar to polymyalgia rheumatica, how is fibromyalgia diagnosed?

A

Literally by excluding everything else

All tests are normal but should be done to exclude inflammation, muscle damage

63
Q

How is fibromyalgia treated?

A

Medications - analgesia (inc. atyptical antidepressants like amitryptiline) – val medication???

Behavioural therapy

Complementary therapy

64
Q

What happens to nociceptors in fibromyalgia?

A

Hypersensitive

65
Q

Why do some people treat fibromyalgia as a made-up disease?

A

No reason for pain receptors to react the way they do

66
Q

Is medication effective in fibromyalgia?

A

Tends not to be

67
Q

What kind of exercise programme may people with fibromyalgia try?

A

Graded

increasing amounts of light exercise

68
Q

Is there any organ pathology in fibromyalgia?

A

No

69
Q

What questions should be asked to someone with suspected polymyalgia rheumatica?

A

Better/worse on exercise?

Headaches, vision problems?

70
Q

What examinations should be performed on someone with suspected polymyalgia rheumatica?

A

Test muscle power - should be normal

Examine and palpate temporal arteries

71
Q

What tests should be performed for suspected polymyalgia rheumatica?

A

Blood test - inflam markers, CK etc.

72
Q

What dose of prednisolone should be given to a patient with suspected polymyalgia rheumatica?

A

15mg

they’ll come back and call it a miracle cure

73
Q

What are some side effects of steroids which should be considered before putting patients on them?

A

Weight gain

Osteoporosis (give vit d and calcium supplements, biphosphonates)

MSK Week 2 2017/18 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions