Lec 11 Everything hurts (fibromyalgia)

Question 1

Fibromyalgia is felt to be a ____ defect of the ____

Answer 1

neurochemical, brain

Question 2

Fibromyalgia has causes no _____ of the joints, bones, or muscles

Answer 2

deformity

Question 3

An example of the thought that fibromyaglia occurs in genetically suscpetible individuals that experience a stressor is _____ _____ syndrome

Answer 3

gulf war

Question 4

The current idea is that fibromyalgia is due to abnormal ____ perception and inactivity, leading to muscle _____

Answer 4

pain; deconditioning

Question 5

In patients with fibromyalgia, serum serotonin is ____, CSF NE is ____, and cerebral spinal substance P is ____

Answer 5

lower, lower, elevated

Question 6

Where does windup for pain occur?

Answer 6

dorsal horn

Question 7

windup is the _____ ____ of pain fibers that causes an exponential increase in the _____ of the response of the neurons leaving the dorsal horn

Answer 7

repetitive stimulation; magnitude

Question 8

Substance P enhances the activation of ___ receptors in the dorsal horn as well as the release of _____

Answer 8

NMDA; glutamate

Question 9

Stimulation of the ____ receptor reduces glutamate and Substance P release, causing a decrease in windup

Answer 9

Mu/opiod

Question 10

What NTs play a role in the descending pain modification?

Answer 10

serotonin, NE

Question 11

Classic triad in fibromyalgia

Answer 11

widespread pain + fatigue + sleep disorder

Question 12

Sleep is often described as restless and non _____

Answer 12

restorative

Question 13

Patients with fibromyalgia often have abnormal stage __ sleep

Answer 13

4

Question 14

What is the term for cognitive issues seen in fibromyalgia?

Answer 14

fibro-fog

Question 15

There is sometimes _____ parasthesia or numbness

Answer 15

nondermatomal

Question 16

Classic tender areas upper body = trapezius, supraspinatus, ____ rib, lateral epicondyle

Answer 16

2nd

Question 17

Classic tender areas lower body = upper buttocks, greater _____, and medial fat pad of the _____

Answer 17

trochanter; knee

Question 18

What 3 non drug things are used in treatment?

Answer 18

education; exercise; sleep

Question 19

_____ are classically used as prescription drug treatment for fibromyalgia

Answer 19

tricyclic antidepressants

Question 20

The other class, besides TCA and SSRI’s typically used is _____

Answer 20

SNRI’s (inhibit reuptake of NE and serotonin)

Question 21

Pregabalin/Lyrica is a ____ that has been FDA approved for use

Answer 21

anti-epileptic