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MSK- Rheumatology > Muscle Disease > Flashcards

Muscle Disease Flashcards

1
Q

How do muscle diseases usually present?

A

Muscle pain Muscle weakness Stiffness Abnormal blood tests

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2
Q

Polymyositis and Dermatomyositis are _______ Myopathies

A

Idiopathic inflammatory myopathies

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3
Q

Who gets polymyositis and Dermatomyositis?

A

40-50yr olds

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4
Q

What does Polymositis and Dermatomyositis increase the risk of?

A

Malignancy

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5
Q

What would you see histologically in idiopathic inflammatory myopathies?

A

muscle fibre necrosis Degeneration Inflammatory cell infiltrate

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6
Q

What is the most common presenting feature for idiopathic inflammatory myopathies?

A

Muscle weakness cant brush hair, climb stairs, get dressed etc

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7
Q

what would the onset of idiopathic inflammatory myopathie’s symptoms be like?

A

Insidious onset Worsening over time

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8
Q

Name some two idiopathic inflammatory disorders?

A

Dermatomyositis

Polymyositis

Inclusion body myositis

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9
Q

What are the cutaneous signs of Dermatomyositis ?

A

Gottrons sign Heliotrope rash Shawl sign

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10
Q

What is this sign called and who gets it ?

A

Gottrons sign

Dermatomyositis

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11
Q

What is this sign called and who gets it ?

A

Helicoid rash

Dermatomyositis

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12
Q

What is this sign called and who gets it ?

A

Shall sign

Dermatomyositis

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13
Q

What is the percentage increased risk of malignancy in dermatomyositis?

A

15%

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14
Q

What is the percentage increased risk of malignancy in polymyositis?

A

9%

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15
Q

What two examinations would you like to preform on the patient in the GP setting in a patient with idiopathic inflammatory myopathy?

A

Confrontational testing- direct testing of power

Isotonic testing - 30 seconds sit to stand

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16
Q

What blood tests would you look at in a patient with suspected idiopathic inflammatory myopathy?

A

CK

Inflammatory markers

autoantibodies- ANA, Anti-Jo-1

17
Q

What would you expect to see in the CK levels in a patient with idiopathic inflammatory myopathy

A

10x the norm

18
Q

What other investigations would you do to make a diagnosis in idiopathic inflammatory myopathy

A

MRI muscle

Muscle Biopsy

the MRI will allow you to identify suitable muscles for biopsy

19
Q

What drug treatment would you consider for idiopathic inflammatory myopathy?

A

Steroids

DMARDs

Biologics- Rituximab

20
Q

What is Inclusion Body myositis?

A

Its abit like polymyositis but it affects distal mucles more often.

CK levels are lower than in polymyositis

Responds poorly to therapy

21
Q

Study this image

A
22
Q

Who gets Polymyalgia Rheumatica ?

A

People over the age of 50

23
Q

What important condition sohuld you look out for in patients with Polymyalgia Rheumatica?

A

Temporal arteritis/giant cell arteritis

24
Q

What are the clinical manifestations of Polymyalgia Rheumatica?

A

Ache in the shoulder and hip girdle

Morning stiffness

Constitutional symptoms

25
Q

What is important to remember about the muscles in patients with Polymyalgia Rheumatica ?

A

They wil be of normal strength

26
Q

What would you find in this test in a patient with Polymalgia Rheumatica?

A

Normal Muscle Strength

27
Q

What symptoms does Tempoisral Arteritis present with?

A

Headache

Scalp tenderness

Jaw claudication

28
Q

How do you treat Polymyalgia Rheumatica?

A

Prednisolone - 15mg

40-60mg if temporal arteritis

Steriods for 1.5 to 2 years

29
Q

what is Fibromyalgia ?

A

Common cause of chronic MSK pain and fatigue

not associated with inflammation

30
Q

Who gets fribromyalgia?

A

Prime working life woman

31
Q

What is the fibromyalgia cycle?

A
32
Q

What are the clincial manifestations of fribromyalgia?

A

Diffuse chronic pain

Unrefeshing sleep

symptoms worsen with excersion

Pins and needles and sensation of swelling

Associated with irritable bowel syndrome

33
Q

What special examination can you preform to diagnose Fibromyalgia?

A

Tender points - 11/18 required

34
Q

What blood test results would you see?

A

Blood tests would be normal

35
Q

How do you treat Fibromyalgia?

A

Education and reasurrance

Anti depressants

Analgesia

Gabapentin and pregabalin

36
Q
A

MSK- Rheumatology (8 decks)

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