fibromyalgia Flashcards
Fibromyalgia is a syndrome characterized by (3) . May occur in patients with an underlying chronic disease: RA, SLE, osteoarthritis, Lyme disease, HIV, sleep apnea. _____ predominance
and onset between _______ years old. In more than half of patients, symptoms preceded by _____________
diffuse pain, stiffness, and fatigue
Female predominance
and onset between 20-60 years old. In more than half of patients, symptoms preceded by physical or emotional stress or flu-like illness
how is the clinical features of fibromyalgia?
diffuse pain that is chronic and migratory. Head to toe. they also have stiffness in the morning , sweling in hands and some paresthesias but symptoms vary day by day
fibromyalgia cognitive difficulties
Fibro- fog–> difficulty in concentrating
how is the sleep with fibromyalgia?
horrible no good rest
drug issues with fribromyalgia?
yep, a lot of allergic symptoms
tender point in fribromyalgia
9!!!!
Examination reveals soft-tissue tender points. Laboratory testing is normal and should be kept to a minimum
In more than half of patients, symptoms preceded by physical or emotional stress or flu-like illness
classification of fibromyalgia but we have moved on from this and it is now more inclusive
Fibromyalgia-pathophysiology
we have no idea but there is some genetic predisposition but what we do know is that there is Abnormalities in central pain processing with heightened pain sensitivity
5-HT2A receptor polymorphism T/T phenotype2
Serotonin transporter3
Dopamine D4 receptor exon III repeat polymorphism4
COMT (catecholamine o-methyl transferase)5
Heterozygous beta-3 adrenergic receptor allele6
all genes that might cause fibromyalgia
Patients display a _____________“detection threshold” to sensory stimuli, but exhibit a __________ “noxious threshold”. This is not just to pressure, but also to other stimuli, e.g., heat, noise, electrical stimulation. This phenomenon is independent of psychological factors such as expectancy or hypervigilance
display a normal “detection threshold” to sensory stimuli, but exhibit a decreased “noxious threshold”. This is not just to pressure, but also to other stimuli, e.g., heat, noise, electrical stimulation. This phenomenon is independent of psychological factors such as expectancy or hypervigilance
_______Influences on Nociceptive Processing
Supraspinal
Abnormalities of neurochemicals that integrate pain, sleep and mood thought to play an important role:
- Serotonin in blood ___________ in subset of patients
2, Substance P ___________ in cerebrospinal fluid of patients
- Serotonin in blood decreased in subset of patients
2, Substance P elevated in cerebrospinal fluid of patients
Fibromyalgia and neuroendocrine dynsfunction
anb. in the hypothalamic-adrenal axis abn. with relative adrenal hyporesponsiveness and there are some growth hormones changes in regulation
In Fibromyalgia, we see abnormal wave pattern seen on EEG in stage
3-4 deep sleep: alpha wave intrusion
At the time of FMS diagnosis, mood disorders are present in _________ primarily depression. Increased prevalence of mood disorders is primarily in tertiary-referral patients. Overlap of neurochemical abnormalities in FMS and depression
At the time of FMS diagnosis, mood disorders are present in 30-50%, primarily depression. Increased prevalence of mood disorders is primarily in tertiary-referral patients. Overlap of neurochemical abnormalities in FMS and depression
FMS treatment
education, pharmacology and non-pharmacologic
non-pharmacologicFMS
education, aerobic exercise and cognitive behavior therapy
No benefit from corticosteroids or nonsteroidal anti-inflammatory drugs in FMS
yep
“Injuries to the musculoskeletal and nervous system that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained or awkward positions”.
repetitive strain injuries
inflammation in repetitive strain injuries
nope
Risk factors for repetitive strain injuries often divided into__________ (pertaining to properties of an individual’tendon or healing capacity) and ___________ pertaining to the load placed on the tendon
Risk factors for repetitive strain injuries often divided into intrinsic factors (pertaining to properties of an individual’tendon or healing capacity) and extrinsic factors pertaining to the load placed on the tendon
histo in repetitive strain injuries
increase in tenocytes
Age Gender Biomechanical abnormalities Prior injury ? Genetic predisposition
intrinsic factors
Training errors
Poor environmental conditions
Inadequate equipment
Fluoroquinolone antibiotics
extrinsic factors
