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Musculoskeletal > Muscle Disease > Flashcards

Muscle Disease Flashcards

Dr J Golla

1
Q

name 2 types of inflammatory myopathies

A

polymyositis

dermatomyositis

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2
Q

Polymyositis and Dermatomyositis are __________ ____________ myopathies

A

idiopathic inflammatory

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3
Q

the female to male ratio in polymyositis and dermatomyositis is 1:2

true or false?

A

false

F:M
2:1

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4
Q

what is the peak incidence age in polymyositis and dermatomyositis?

A

40-50 years

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5
Q

what is there an increased incidence of in polymyositis and dermatomyositis?

A

malignancy

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6
Q

what are the histological features of polymyositis and dermatomyositis?

A

muscle biopsy include muscle fibre necrosis, degeneration, regeneration and an inflammatory cell infiltrate.

Underlying cause is not clear

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7
Q

what is the most common clinical feature in polymyositis and dermatomyositis?

A

muscle weakness

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8
Q

what cutaneous sign is seen in dermatomyositis in the hands?

A

gottrons sign

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9
Q

what cutaneous rash is seen in dermatomyositis on the face?

A

heliotrope rash

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10
Q

what cutaneous sign is seen in dermatomyositis on the back?

A

shawl sign

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11
Q

what other organs are involved in dermatomyositis?

A

lung - ILD
oesophageal - dysphagia
cardiac - myocarditis
other - Raynaulds

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12
Q

there is a __% incidence of malignancy in dermatomyositis and _% incidence of malignancy in polymyositis

A

15% - dermatomyositis

9% - polymyositis

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13
Q

outline the typical history in dermatomyositis and polymyositis?

A 
tired muscles and pain
DM and thyroid disease
steroids and statins
alcohol, drug use
weight loss, cough, breathlessness, Raynaulds
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14
Q

what 2 tests are performed in dermatomyositis and polymyositis?

A

confrontational (power) and isotonic (30 sec sit and stand)

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15
Q

what is seen in the blood of someone with dermatomyositis and polymyositis?

A

CK
inflammatory markers
ANA
Anti Jo-1

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16
Q

what other investigations can help diagnose in dermatomyositis and polymyositis?

A

electromyography - EMG
muscle biopsy
MRI

17
Q

what is seen on biopsy of the muscle of someone with dermatomyositis and polymyositis?

A

Perivascular inflammation and muscle necrosis

18
Q

what is the treatment in dermatomyositis and polymyositis?

A 
Glucocorticoids
Azathioprine
Methotrexate
Ciclosporin
IV immunoglobulin
Rituximab
19
Q

Polymyalgia Rheumatica is seen in people over the age of what?

A

50 years old

20
Q

Incidence of Polymyalgia Rheumatica is higher in southern regions

true or false?

A

false

northern

21
Q

what conditions is Polymyalgia Rheumatica associated with

A

Associated with temporal arteritis/giant cell arteritis (15%)

22
Q

what are the clinical manifestations seen in Polymyalgia Rheumatica?

A

ache is shoulder and hip
morning stiffness
strength is normal

23
Q

what does temporal arteritis cause?

A

headache
scalp tenderness
jaw claudication
visual loss

24
Q

how do you diagnose Polymyalgia Rheumatica?

A

raised ESR, PV, CRP

temporal artery biopsy

25
Q

what is the treatment in Polymyalgia Rheumatica?

A

low dose steroids

26
Q

fibromyalgia is associated with inflammation

true or false?

A

false!

Not associated with inflammation

27
Q

in what sex and age is fibromyalgia most common?

A

female (6:1)

22-50 years old

28
Q

what are the clinical manifestations in fibromyalgia?

A 
pain in neck, shoulder and lower back
chronic
worse with exception
swelling
fatigue
pins and needles
general unwellness
29
Q

what are the clinical findings in fibromyalgia?

A

excessive tenderness on palpitation

30
Q

what is the diagnosis criteria in fibromyalgia?

A

widespread pain >/= 3 months
unrefreshing sleep, fatigue

no other condition explains pain

31
Q

what is the treatment in fibromyalgia?

A 
exercise
acupuncture
anti-depressants
analgesia
gabapentin and pregablin
32
Q

diagnose:

63 year old
male
pain in shoulders and hips
raised PV and CRP
normal CK
A

Polymyalgia Rheumatica

33
Q

what is the treatment in Polymyalgia Rheumatica? drug? mg? duration?

A

Prednisolone 15mg reducing course over 6 months

34
Q

diagnose:

64 year old
man
heavy arm for 6 months
tiring climbing stairs
EMG suggests myositic change in the proximal muscles
raised CK and CRP
A

dermatomyositis

35
Q

how does Alan Muldoon make his boyfriend scream during sex?

A

he calls him and tells him about it

Musculoskeletal (37 decks)

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