Approach to a FMG patient

Question 1

Take a thorough, compassionate history, ruling out underlying pathology (? ?) and ?.

Bloods may help rule out underlying pathology;
o FBC: ?, ? or ?.
o ESR, CRP: ? disease.
• Consider ?/? if raised inflammatory markers.
o TFTs: ?.
o Calcium, alkaline phosphatase - ?, ?

Answer 1

red flags
depression
anaemia
lymphopenia
lupus
inflam
ANA/RF
hypo
osteomalacia
hyperparathyroidism

Question 2

? ? is central to management.
o Explain that the individual’s disease does not reflect ? or
?. The model of a self-? cycle involving loss of ?
and ? is often readily accepted.

Answer 2

pt ed
inflam
damage
perpetuating
sleep
pain

Question 3

? advice is important.
o Sensible increases in ? level help to improve ?, and thus can have beneficial effects on symptoms.
o ? ? therapy involves graded increases in ?
exercises, and is a more formal approach.

Answer 3

lifestyle
activity
graded exercise
aerobic

Question 4

Low-dose ? (10-?mg nocte).

o Can be very effective, reducing the excessive transmission of ?
signals, and increasing ? sleep.
o Many people with fibromyalgia will be ? to even small doses of ?.

Answer 4

amitriptyline
pain
restorative
intolerant
amitriptyline

Question 5

Self-help strategies.

0 ? ? approach, ? techniques and other ‘? strategies’ should be encouraged

Answer 5

cog behavioural
relaxation
coping