Brainscape's Knowledge GenomeTM

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


See full index

MSS 2 > Fibromyalgia vs. Polymyalgia > Flashcards

Fibromyalgia vs. Polymyalgia Flashcards

1
Q

As what type of rheumatic disease is polymyalgia rheumatica (PMR) classified?

A
  • subgroup of vasculitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

As what type of rheumatic disease is fibromyalgia classified?

A
  • non-articular rheumatism (musculoskeletal aches and pains without arthritis).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What types of rheumatic conditions are primary care docs most likely to see?

A
  • non-articular= fibromyalgia, bursitis, tendinitis, tenosynovitis, viral myalgia, RSD, PMR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A 35 y/o female complains of “pain all over.” Her multiple aches and pains have been present for at least 18 months and are associated with AM stiffness for at least 2 hrs. PE fails to reveal any true joint abnormality and labs are unremarkable. She has associated sleep disturbance and weather change aggravates her symptoms. What is her Dx?

A
  • primary fibromyalgia syndrome= no inflammation, consistent symptom spectrum, no underlying cause.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

*** What is fibromyalgia?

A
  • non-articular rheumatism characterized by:
    1. chronic musculoskeletal aches, pains, and stiffness (mostly in muscles, articular, and periarticular areas).
    2. tender points and exaggerated tenderness in specific spots.
    3. absence of articular pathology.
  • often associated with sleep disturbance.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the demographics of fibromyalgia?

A
  • age 35-50, mainly women.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What diseases are often associated with fibromyalgia?

A
  • SLE
  • lyme disease
  • IBD
  • carpal tunnel syndrome
  • tendonitis/bursitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the aggravating factors of fibromyalgia?

A
  • cold or humid weather
  • non-restorative sleep
  • physical/mental fatigue
  • excess physical activity
  • physical inactivity
  • anxiety/stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the relieving factors of fibromyalgia?

A
  • warm/dry weather
  • hot shower/bath
  • restful sleep
  • moderate activity
  • stretching
  • massage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What will you see on PE of a pt with fibromyalgia?

A
  • multiple tender points
  • mild soft tissue swelling (fingers)
  • skin pinch tenderness
  • hyperemia of skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

*** Will you see muscle weakness in fibromyalgia?

A
  • NO

* neuro and joint exams will also be normal.

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

What are the criteria for fibromyalgia?

A
  • widespread aching more than 3 months
  • tenderness at 12 of 14 specified sites
  • skin roll tenderness in upper scapular region
  • disturbed sleep
  • NORAML labs (CBC, ESR, CMP, serologies, EEG, EMG).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the ddx for fibromyalgia?

A
  • psychogenic rheumatism
  • RA
  • palindromic rheumatism
  • osteoarthritis
  • polymyalgia rheumatica (PMR)
  • hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Should you biopsy a pt with fibromyalgia to diagnose?

A
  • NO. It is a clinical diagnosis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

*** How do we treat fibromyalgia?

A
  • reassurance
  • origin of pain
  • relief of mechanical stresses (aquatic exercise)
  • medical treatment: NSAIDs and ANTIDEPRESSANTS (TCAs= amitriptyline)
  • heat, massage, OMT, relaxation, injections, acupuncture…
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Should you use narcotics to treat fibromyalgia?

A
  • NO!
17
Q

Should you use steroids to treat fibromyalgia?

A
  • NO
18
Q

What are some additional medical therapies used to treat fibromyalgia?

A
  • SSRIs
  • tramadol
  • duloxetine (SNRI)
  • pregabalin
  • combination is better than solo therapy.
19
Q

A 63 y/o female presents to the office with the complaint of difficulty getting out of a chair. She also has vague symptoms such as fatigue and lack of energy in association with morning stiffness and aching in the proximal portions of her arms and legs. Lab data reveals a mild anemia, normal biochemistry profile, and a Westergren sedimentation rate of 75 mm/hr. PE is unremarkable. What is the Dx?

A
  • Polymyalgia rheumatica (PMR)
20
Q

*** What is the characteristic symptom of Polymalgia Rheumatica (PMR)?

A
  • PROXIMAL girdle muscle STIFFNESS

* aka shoulders and hips

21
Q

*** What is Polymalgia Rheumatica (PMR)?

A
  • pain in neck, shoulders, and pelvic girdle for at least 1 month.
  • morning stiffness and gelling without muscle atrophy or weakness.
  • age greater than 50 and ESR greater than 50 (aka the 50/50 club)!
22
Q

Will you see relief of symptoms within 4 days with a low dose (10-15 mg) of prednisone per day?

A
  • YES
23
Q

How long does polymyalgia rheumatica typically last?

A
  • 2 years

* whereas fibromyalgia goes on forever.

24
Q

What should be on your DDx for PMR?

A
  • RA
  • SLE
  • viral myalgias
  • polymyositis
  • multiple myeloma
  • osteoarthritis
  • fibromyalgia
  • occult cancer
  • occult infection
  • ENDOCRINE DISTURBANCE
25
Q

Will labs be normal in PMR?

A
  • YES, except for ESR (greater than 50)
26
Q

** How do you differentiate PMR from polyMYOSITIS?

A
  • MUSCLE ENZYMES will be NORMAL in PMR.

* but elevated in polymyositis

27
Q

*** What is the treatment of choice for PMR?

A
  • CORTICOSTEROIDS (low dose)

* may add methotrexate, but conflicting reports.

28
Q

** To what could PMR lead?

A
  • sudden blindness 7 years later due to TEMPORAL ARTERITIS

- RA

MSS 2 (15 decks)

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