Misc - fibro, mechanical back pain, amyloidosis Flashcards
1
Q
Define fibromyalgia.
A
- widespread pain throughout the body with tenderness at specific anatomical points throughout the body
- pain present >3 months with exclusion of other causes
- pain at 11-18 sites on palpation
2
Q
SX of fibromyalgia?
A
- pain all over - worse on stress, cold and heat set it off
- fatigue - can be extreme
- non-restful sleep
- agitated
- low mood and tearful
- headache + diffuse abdominal pain
3
Q
Ix for ruling out what Ddx in fibro?
A
- SLE - dsDNA and ANA
- PMR - ESR and CRP
- hypothyroidism - TFTs
- high Ca2+
- low Vit D
- myopathies - CK
- inflammatory arthritis - CRP + examination
4
Q
What makes back pain a mechanical back pain?
A
- varies over time and with exercise
- patient otherwise well
- present 20-55
- lumbosacral region, buttocks, thigh
5
Q
What is neurological back pain?
A
- caused by nerve root compression
- pain shooting down to the feet/toes on one side or the other
- numbness and parathesia across same dermatomes each side
- associated functional/reflex changes
6
Q
What are some red flags for back pain?
A
- night pain
- incontinence
- focal neurology
- trauma
- systemically unwell
- Hx of malignancy or trauma
- osteoporosis
- <16 or >50
7
Q
define amyloidosis.
A
deposition of protein aggregates called amyloid in different organs.
8
Q
There’s 2 types of amyloidosis. tell me a bit about both of them.
A
- light chain amyloidosis associated with plasma cells which has a rapid clinical course
- reactive amyloidosis which is secondary to other automimmune/infectious/malignant disease
always think amyloidosis when a patient with a chronic inflmammatoyr or infectious disease presents with new onset kidney, liver or GI injury
9
Q
How do you diagnose amyloidosis?+ treat?
A
- biopsy of the dysfunctional organ and stain with CONGO RED STAIN
- show’s apple-green birefringence under polarised light
- treat underlying disease is the only way (steroids may be helpful in rapidly progressing disease
