Lec 9 Myositis

Question 1

Which form of myositis has the worse prognosis?

Answer 1

inclusion body myositis

Question 2

The inflammatory infiltrate is typically predominantly ______

Answer 2

lymphocytes

Question 3

Dermatomyositis is characterized by primarily ____ and _____ lymphocytic infiltrate

Answer 3

perivascular, perifasicular

Question 4

There is _____ atrophy and fibrosis in dermatomyositis

Answer 4

perifasicular

Question 5

Polymyositis is characterized by ____ inflammation ____ the fascicle

Answer 5

endomysial; within

Question 6

Characteristic ____ lined ____ are seen in inclusion body myositis

Answer 6

intracellular vacoules

Question 7

What are the 2 myositis specific antibodies?

Answer 7

Anti Jo1; Anti Mi 2

Question 8

Anti Jo 1 is an antibody against _____

Answer 8

histidyl t-RNA synthetase

Question 9

Anti Mi2 is an antibody against a ____

Answer 9

helicase

Question 10

Muscle weakness is typically in the ___ muscles (ie shoulders

Answer 10

proximal

Question 11

What are gottron papules?

Answer 11

flat plaques on the knuckles

Question 12

What is a heliotrope rash?

Answer 12

erythmatous rash above the eyelids

Question 13

What nail changes are often seen?

Answer 13

nail fold capillary changes–>hyperemic

Question 14

What internal organ is often also affected?

What does it cause?

Answer 14

esophagus,

dysphagia

Question 15

“___ hands” are a characteristic finding

Answer 15

mechanic’s

Question 16

What 2 serum muscle enzymes are often elevated?

Answer 16

creatinine phosphokinase, aldolase

Question 17

What other enzymes are often elevated?

Answer 17

transaminases, lactate dehydrogenase

Question 18

The characteristic EMG shows increased _____ and general _____

Answer 18

recruitment; irritability

Question 19

Inclusion body myositis is characterized by ____ response to ____

Answer 19

poor, corticosteroids

Question 20

Common organ involvement that can lead to death:

Answer 20

lung, heart

Question 21

____ muscle weakness can lead to increased infection risk

Answer 21

respiratory

Question 22

There is an notable increased risk of ____ in these patients

Answer 22

cancer

Question 23

Peak incidence of cancer is within ___ years of onset

Answer 23

2

Question 24

What is probably the best “pivot point” in the ddx of myositis?

Answer 24

increased CPK

Question 25

Anti ___ is associated with a good response, while anti ____ and ____ is associated with partial response

Answer 25

Mi2

Jo1, SRP

Question 26

____ are the mainstay of treatment

Answer 26

corticosteroids

Question 27

Besides corticosteroids, long-term _____ therapy may also be used

Answer 27

immunosupression