Muscle Disease

Question 1

what is polymyositis

Answer 1

autoimmune inflammatory disease of proximal muscles

Question 2

what cells mediate polymyositis

Answer 2

CD8 T cells

Question 3

antibody present in myositis

Answer 3

Anti-jo

Question 4

presentation of polymyositis

Answer 4

symmetrical proximal muscle weakness - shoulders + pelvic girdle
- difficulty climbing stairs/getting dressed

Question 5

what organ can become involved in polymyositis and is a poor prognostic sign

Answer 5

oesophageal - dysphagia

Question 6

what is dermatomyositis

Answer 6

immune complex mediated myositis + cutaneous features

Question 7

characteristic skin features in dermatomyositis

Answer 7

gottrons papules - red patches on knuckles
heliotrope rash
shawl sign

Question 8

what enzyme is raised in polymyositis + dermatomyositis

Answer 8

CK

Question 9

what is important about polymyositis + dermatomyositis

Answer 9

they are paraneoplastic syndromes - could be underlying malignancy

Question 10

what malignancies are associated with polymyositis + dermatomyositis

Answer 10

lung
breast
ovarian
gastric

Question 11

definitive test for polymyositis + dermatomyositis

Answer 11

muscle biopsy

- inflammation + necrosis

Question 12

treatment of polymyositis + dermatomyositis

Answer 12

prednisolone (40mg) + methotrexate/azathioprine

Question 13

how can cutaneous features of dermatomyositis be treated

Answer 13

topical steroids

Question 14

male, distal asymmetrical muscle weakness. non-immune mediated
most likely what condition?

Answer 14

inclusion body myositis

Question 15

what is polymyalgia rheumatica

Answer 15

idiopathic inflammation + myalgia of shoulders + hip girdle

Question 16

who is affected by polymyalgia rheumatica

Answer 16

women, >50 years old

Question 17

symptoms of polymyalgia rheumatica

Answer 17

bilateral pain in shoulder + hip girdle
morning stiffness - no weakness
systemic upset- weight loss, fatigue, depression, fever

Question 18

polymyalgia rheumatica is associated with what condition

Answer 18

giant cell arteritis

Question 19

treatment of polymyalgia rheumatica

Answer 19

low dose steroids (15mg)

Question 20

treatment of polymyalgia rheumatica with

• GCA
• GCA + Vision changes

Answer 20

GCA - 40mg

+ Vision changes - 60mg

Question 21

what is fibromyalgia

Answer 21

chronic widespread muscle pain + fatigue

- unknown pathophysiology

Question 22

who gets fibromyalgia

Answer 22

young women

Question 23

symptoms fibromyalgia

Answer 23

widespread muscle pain
fatigue + poor sleep
poor concentration
depression / anxiety issues linked