Fibromyalgia Flashcards

1
Q

fibromyalgia was once defined as a chronic, generalized, MSK pain disorder with the presence of ___ of ___ tender point sites on physical exam

A

11 of 18

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2
Q

focus of fibromyalgia is now based on ___ rather than tender points

A

symptoms

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3
Q

core symptoms of FM

A
  • chronic widespread pain
  • fatigue
  • sleep disturbance
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4
Q

FM: chronic widespread pain » details

A
  • R and L sides of body
  • above and below waistline
  • covers axial skeleton
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5
Q

FM dx

A
  • presence of core sx along with physical function limitations
  • at least 3 months duration of sx
  • lab testing
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6
Q

FM and lab testing

A
  • can’t dx FM

- rule out anemia, electrolyte disturbances, and thyroid disease

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7
Q

FM: 75% of pts report

A

troublesome headaches (ranges from occasional to chronic migraines)

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8
Q

FM: 40% of pts have

A

IBS

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9
Q

FM: 65% of pts have

A

depression/anxiety

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10
Q

FM: ~50% of pts have

A
  • personality disorder

- obesity

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11
Q

FM locus of control

A

primarily external

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12
Q

Other associated conditions with FM

A
  • PTSD

- sexual abuse

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13
Q

relationship of FM and PTSD

A
  • 45% of FM pts meet PTSD criteria

- FM and PTSD are risk factors for one another

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14
Q

FM and sexual abuse

A
  • hx of sexual abuse associated with chronic nonspecific pain
  • hx of rape associated with FM
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15
Q

This has been found to increase exercise adherence in pts with FM

A

motivational interviewing

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16
Q

multifactorial tx strategies for FM

A
  • education
  • exercise
  • modalities
  • medication
  • nutrition
  • stress mgmt and relaxation
17
Q

effective exercise types for FM pts

A
  • stretching
  • aquatic therapy
  • strengthening
  • aerobic exercise
18
Q

FM and nutrition: caution the use of

A
  • caffeine
  • alcohol
  • nicotine
19
Q

FM and nutrition: suggested nutritional supplements

A
  • calcium/magnesium (1000-1500 mg/day)

- B complex

20
Q

common meds seen with FM pts

A
  • antidepressants
  • antiepileptics
  • muscle relaxants
  • opioids
21
Q

FM: antidepressants (tricyclics)

A

reduce pain, fatigue, and sleep disturbances

22
Q

FM: antidepressants (SSRIs)

A

slight benefit for pain reduction

23
Q

FM: antidepressants (SNRIs)

A

some benefit for reducing pain, sleep disturbances, and depressed mood

24
Q

FM: antiepileptics

A

may reduce pain in some pts

25
Q

FM: muscle relaxants

A
  • can improve pain and sleep quality, but not fatigue

- when combined with antidepressants or antiepileptics

26
Q

FM: opioids

A
  • provide no benefit

- increased rate of adverse effects

27
Q

FM: withdrawal of these can increase sx

A
  • corticosteroids
  • immunosuppressive drugs
  • narcotics