Fibromyalgia

Question 1

Fibromyalgia diagnostic criterion (previously defined by ACR)

Answer 1

11 of 18 sites perceived as painful

Question 2

Definition of FM

Answer 2

A pain syndrome characterized by

Chronic widespread musculoskeletal pain and tenderness
+
Neuropsychological symptoms

Question 3

True or False:

Routine lab and radiographic tests yield normal results in FM.

Answer 3

TRUE

Question 4

Serve as triggers for the more widespread pain in FM

Answer 4

Peripheral Pain Generators

• Arthritis, bursitis, tendinitis, neuropathies, and other inflammatory or degenerative conditions
• Joint hypermobility and scoliosis
• Infectious, metabolic, or psychiatric conditions

Question 5

Routinely tested in FM

Answer 5

CBC
ESR OR CRP
TSH

Question 6

May be requested in evaluating for FM based on Hx and PE

Answer 6

Metabolic panel
ANA
anti-SSA and anti-SSB
RF, anti CCP
CPK
Hep C, HIV, Lyme dse serologies
Spine and joint radiograph

Question 7

Neurotransmitter involved in FM

Answer 7

SEROTONIN

Question 8

Tx for FM patients presenting with pain + sleep disturbance

Answer 8

cyclobenzaprine (muscle relaxant)
amitriptyline (sedating antidepressant)
gabapentine, pregagabalin (alpha-2-delta ligands)

Question 9

Tx for FM patients presenting with pain + fatigue, anxiety, or depresssion

Answer 9

duloxetine, milnapcipran