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Musculoskeletal > Muscle Disease > Flashcards

Muscle Disease Flashcards

1
Q

What is polymyositis?

A

Idiopathic inflammatory myopathy

Causes symmetrical proximal weakness

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2
Q

What is dermatomyositis

A

Polymyositis
+ cutaneous involvement
Also has higher malignancy potential

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3
Q

What is the peak incidence age of poly- and dermatomyositis

A

40-50

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4
Q

How are the sexes affected by poly- and dermatomyositis? [incidence ratio]

A

M:F
1:2

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5
Q

What are the presenting clinical features of polymyositis?

A

Symmetrical proximal muscle weakness
Progressively worsens
Trouble with specific tasks e.g stairs, combing hair

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6
Q

List 3 cutaneous signs of dermatomyositis

A

Gottron’s sign
Heliotrope rash
Shawl sign

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7
Q

List 4 other features of polymyositis

A

Constitutional symptoms
ILD
Oesophageal dysphagia
Myocarditis

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8
Q

Which age group and sex has the greatest risk of developing malignancies with dermatomyositis?

A

Men older than 45

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9
Q

What are the most commonly acquired malignancies with dermatomyositis?

A 
Ovarian
Breast 
Gastric
Lung
Bladder
Colon
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10
Q

Name 2 ways to examine patients for polymyositis

A

Confrontational - direct testing of power

Isotonic - 30s sit to stand reps

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11
Q

List 4 investigations that can be used to check for polymyositis

A

Blood tests
Electromyography (EMG)
Muscle biopsy
MRI

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12
Q

What would a positive blood test for polymyositis show?

A

Raised muscle enzymes (CK)

Inflammatory markers

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13
Q

Which autoantibodies are associated with polymyositis?

A

ANA

Anti-Jo-1

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14
Q

What does EMG show if a patient has polymyositis?

A

Increased fibrillations

Abnormal motor complexes

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15
Q

What is the most definitive test for polymyositis?

A

Muscle biopsy

  • shows perivascular inflammation and muscular necrosis
  • mediated by T cytotoxic cells
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16
Q

List 2 types of treatments for polymyositis

A

Corticosteroids + Immunosuppressants

~ 40mg prednisolone
Azathioprine/ methotrexate

17
Q

Which other drugs may be used to treat polymyositis?

A

Ciclosporin

IV immunoglobulin

18
Q

What is Inclusion Body Myositis (IBM)?

A

Inflammatory muscle disease
Slower onset weakness and wasting
Both proximal and distal muscle involvement
Asymmetrical

19
Q

Is IBM more common in men or women?

A

Men; M:F

3:1

20
Q

What age group does IBM typically affect?

A

> 50

21
Q

How do CK levels in IBM compare to that of polymyositis?

A

Lower than with PM

22
Q

What is seen on muscle biopsy of people with IBM

A

Inclusion bodies

23
Q

Does IBM respond to therapy?

A

Poorly

24
Q

Which condition is Polymyalgia Rheumatica associated with?

A

Giant Cell Arteritis

25
Q

What is Temporal/Giant Cell Arteritis?

A

Granulomatous arteritis of large vessels

26
Q

How does Giant Cell Arteritis present?

A 
Headache
Jaw claudication
Scalp tenderness
Vision loss
Non-pulsatile enlarged temporal arteries
27
Q

What is a definitive investigation for Giant Cell Arteritis?

A

Temporal artery biopsy

- beware of skip lesions

28
Q

How is Giant Cell Arteritis treated?

A

Low dose steroid usually suffices

- higher dose for temporal arteritis

29
Q

Is fibromyalgia an inflammatory condition?

A

No

30
Q

Which demographic is most commonly affected by Fibromyalgia?

A

Women

Aged 22-50

31
Q

Name 2 possible triggers of fibromyalgia

A

Emotional/

Physical trauma

32
Q

How does fibromyalgia present?

A 
Very varied
Diffuse and chronic pain
Worse with exertion, fatigue and stress
Feels swollen
Unrefreshing sleep
Parasthesia
33
Q

How do inflammatory markers change in people with fibromyalgia?

A

They don’t

34
Q

What pharmacological treatment is used for fibromyalgia?

A

Antidepressants e.g. amytriptiline
Analgesia
Gabapentine

Musculoskeletal (19 decks)

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