Muscle disease and vasculitis Flashcards
what muscle disease is characterised by weakness
inflammatory myopathies - polymyositis and dermatomyositis
what muscle disease is characterised by pain and stiffness
polymyalgia rheumatics
what muscle disease is characterised by pain and fatigue
fibromyalgia
polymyositis and dermatomyositis affect proximal/distal muscles on the extremities
proximal
who is more likely to get polymyositis and dermatomyositis
women and middle age
dermatomyositis/polymyositis has an increased risk of malignancy
both do, dermatomyositis is more elevated risk
what cancers are common in dermamyositis/polymyositis
ovarian breast stomach colon lung bladder`
in who is cancer most likely in dermamyositis/polymyositis
men over 45
what is gottron’s sign
reddish, purputic rash on MCP/DIP, dorsal hand
what is a heliotrope rash
reddish, purputic rash around eyes
what is a shawl sign
reddish, purputic rash on chest on upper back
what is confrontational testing
testing that applies force to muscle group to test strength
what is isotonic testing
testing for muscle fatigue, 30s how fast can you stand/sit
what antibodies are present in polymyositis
ANA
anti-Jo-1
what may electromyography see on dermatomyositis/polymyositis
increased fibrillation
abnormal motor potentials
what would a muscle biopsy see in dermatomyositis/polymyositis
perivascular inflammation and muscle necrosis
what would a muscle MRI see in dermatomyositis/polymyositis
muscle inflammation, oedema, fibrosis, calcification
what is polymyalgia rheumatica associated with
temportal/giant cell arteritis
polymyalgia rheumatica affects proximal/distal muscles
proximal
fibromyalgia affects proximal/distal muscles
proximal
who is fibromyalgia more common in
women, age 20-50
more common with emotional/physical trauma
tender points of fibralgia
upper back/shoulder base of neck elbow knee hip chest
true/false - analgesics work effectively in fibromyalgia
false - they can in high doses but avoid opiods at all costs. SSRI or tricyclic antidepressants may work to relieve pain
what is vasculitis
inflammation of the blood vessels
what is primary vasculitis
inflammatory response targeting vessel walls
what is secondary vasculitis
vasculitis triggered by infection, drug, toxin or inflammatory disorder/malignancy
takayasu vasculitis is large/small vessel and who does it affect
large
<40 and females
who does giant cell arthritis affect, where is it more common and what is a complication
over 50, polymyalgia rheumatica
temporal arteries
vision loss, temporary or permanent
treatment duration for giant cell arteritis?
18-24 months
EGPA is more commonly known as?
churg-strauss syndrome
GPA is characterised by and is more common in who
granulomatous inflammation
30-50 and men
what does EGPA have in addition to the presentation to GPA
high serum eosinophils
late presentation of asthma
complication of microscopic polyangiitis
renal failure
what immunoglobulin mediates henoch-schonlein purpura and where/who is it more commno in
IgA
skin, GI tract, kidneys, joints, lungs and CNS
children, preceding URTI, GI infection,pharyngeal infection
what is cANCA associated with
GPA
what is pANCA associated with
EGPA and MPA
what is more sensitive than cANCA
PR3
what is more sensitive than pANCA
MPO
true/false - c/pANCA is used to monitor disease progression
true
