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Muscle Disease Flashcards

1
Q

What is the cause of polymyositis and dermatomyositis?

A

None- they are idiopathic

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2
Q

Which sex is polymyositis/dermatomyositis more common in?

A

Females

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3
Q

What is the peak age incidence for polymyositis/dermatomyositis?

A

40-50

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4
Q

Do polymyositis/dermatomyositis have an increased risk of malignancy?

A

Yes

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5
Q

What is the difference between polymyositis/dermatomyositis?

A

They are the same, with the exception that dermatomyositis involves the skin

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6
Q

What is important to know about dermatomyositis in males over 50?

A

It is often paraneoplastic- these patients should be screened for malignancy

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7
Q

Muscle fibre necrosis, degeneration, regeneration and inflammatory cell infiltrate on histology suggests what?

A

polymyositis/dermatomyositis

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8
Q

How does the muscle weakness come on in polymyositis/dermatomyositis?

A

Insidiously, worsening over months

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9
Q

Where is the weakness usually found in polymyositis/dermatomyositis? Is it symmetrical?

A

Usually in proximal muscles (hip and shoulder girdle) and is usually symmetrical

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10
Q

What is the main clinical feature of polymyositis/dermatomyositis?

A

Muscle WEAKNESS

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11
Q

What is Gottron’s sign? What disease is it associated with?

A

Dermatomyositis- papules over the joints in the hands

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12
Q

What disease will show a heliotropic rash around the eyes?

A

Dermatomyositis

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13
Q

What other organs can be involved in polymyositis/dermatomyositis?

A

Lungs, oesophagus, heart

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14
Q

What is the lung involvement in polymyositis/dermatomyositis?

A

Interstitial lung disease/pulmonary fibrosis

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15
Q

What is the oesophageal involvement in polymyositis/dermatomyositis?

A

Dysphagia

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16
Q

What is the cardiac involvement in polymyositis/dermatomyositis?

A

Myocarditis

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17
Q

What are 4 systemic features of polymyositis/dermatomyositis?

A

Raynaud’s, weight loss, fever, polyarthritis

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18
Q

Which out of polymyositis/dermatomyositis has a higher risk of malignancy?

A

Dermatomyositis

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19
Q

What PMH might be important when suspicious of polymyositis/dermatomyositis?

A

Diabetes, thyroid disease

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20
Q

What drug use might be important when suspicious of polymyositis/dermatomyositis?

A

Steroids, statins

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21
Q

What is the sit to stand test (isotonic testing)?

A

How many times can a person sit to stand in 30 seconds

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22
Q

What blood tests would be useful for polymyositis/dermatomyositis?

A

Creatinine kinase, inflammatory markers, electrolytes, calcium, PTH, TSH

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23
Q

When is creatinine kinase released?

A

When muscles start to breakdown

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24
Q

Which autoantibodies may be found in polymyositis/dermatomyositis? Which one is SPECIFIC?

A

ANA

Anti-Jo-1 (SPECIFIC)

25
Q

What test can check muscle inflammation?

A

Electromyography

26
Q

What is the definitive test (gold standard) for polymyositis/dermatomyositis?

A

Muscle biopsy

27
Q

Do polymyositis/dermatomyositis have the same patterns on muscle biopsy?

28
Q

Could you use an MRI for polymyositis/dermatomyositis?

29
Q

How do you treat polymyositis/dermatomyositis initially?

A

High dose steroids to suppress initial inflammation then lower dose while starting a DMARD

30
Q

What should be used to treat polymyositis/dermatomyositis in patients who don’t respond to DMARDs?

A

IV immunoglobulin and rituximab

31
Q

What is a condition that can be misdiagnosed as polymyositis?

A

Inclusion body myositis

32
Q

What age group and sex is inclusion body myositis most common in?

A

> 50 years, more commonly men

33
Q

Which muscles does inclusion body myositis usually affect?

A

Distal ones

34
Q

Is the weakness in inclusion body myositis symmetrical?

A

No, it is usually asymmetrical

35
Q

Is inclusion body myositis an autoimmune condition?

36
Q

Will CK levels be raised in inclusion body myositis?

A

Yes, but not as much as in polymyositis

37
Q

What does muscle biopsy show in inclusion body myositis?

A

Inclusion bodies

38
Q

Does inclusion body myositis respond to treatment?

39
Q

What are the 3 main inflammatory muscle conditions?

A
  • Polymyositis
  • Dermatomyositis
  • Inclusion body myositis
40
Q

What age and location is polymyalgia rheumatica associated with?

A
  • Over 50s

- Northern countries

41
Q

What other medical condition is polymyalgia rheumatica associated with?

A

Temporal/giant cell arteritis

42
Q

What is the main clinical feature of polymyalgia rheumatica?

A

PAIN AND STIFFNESS

43
Q

Where usually is the ache found in polymyalgia rheumatica? Is it symmetrical?

A

Usually the hip and shoulder girdle, normally symmetrical

44
Q

When does the stiffness from polymyalgia rheumatica occur and how long does it last?

A

In the morning, can last a few hours and then get better

45
Q

What symptoms as well as the muscle problems can occur in polymyalgia rheumatica?

A

Fatigue, anorexia, weight loss, fever

46
Q

Is there a specific test for polymyalgia rheumatica?

47
Q

How long does polymyalgia rheumatica last?

A

18 months- 2 years

48
Q

What is the best medication for polymyalgia rheumatica?

A

Steroids (rapid and dramatic response)

49
Q

Is polymyalgia rheumatica inflammatory?

50
Q

What is the normal starting dose of steroids in any condition?

51
Q

When should 40mg/day of prednisolone be given in polymyalgia rheumatica?

A

If there is giant cell arteritis causing headache only

52
Q

What dose of steroids should be given to a polymyalgia rheumatica patient with giant cell arteritis causing visual disturbances?

A

60mg/day prednisolone

53
Q

Is fibromyalgia an inflammatory condition?

54
Q

Fibromyalgia is a chronic cause of pain, usually occurring in who?

A

Women under 50

55
Q

What factors may trigger the beginning of fibromyalgia?

A

Emotional or physical trauma, poor sleep pattern

56
Q

What is the main clinical feature of fibromyalgia?

57
Q

Does exercise make pain better or worse in fibromyalgia?

58
Q

Is there a diagnostic test for fibromyalgia?

59
Q

Is medication useful for fibromyalgia? What could you give patients?

A

Not really, only give analgesics (amitryptilline, gabapentin)

MSK (6 decks)

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