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musculoskeletal > Muscle Diseases > Flashcards

Muscle Diseases Flashcards

1
Q

what characterises inflammatory myopathies

A

weakness

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1
Q

what characterises polymyalgia rheumatica

A

pain and stiffness

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1
Q

what characterises fibromyalgia

A

pain and fatigue

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2
Q

what is myopathy

A

a disease in which the muscle fibres don’t function properly

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3
Q

what is polymyositis

A

idiopathic inflammatory myopathy that causes symmetrical, proximal muscle weakness

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4
Q

what is dermatomyositis

A

polymyositis + typical cutaneous manifestations

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5
Q

which gender is more likely to get polymyositis

A

females

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6
Q

peak incidence age of polymyositis

A

40-50

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7
Q

pathophysiology of polymyositis

A

CD8+ T cells and macrophages surround, invade and destroy healthy, non-necrotic muscle fibres

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8
Q

symptoms of polymyositis

A

symmetrical, proximal muscle weakness in the upper and lower extremities
often present with a specific problem
insidious onset

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9
Q

clinical sign of polymyositis

A

muscle wasting

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10
Q

name 2 types of examination tests you can do for polymyositis

A

confrontational and isotonic testing

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11
Q

confrontational testing for polymyositis

A

comparing your strength to the patient’s

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12
Q

isotonic testing for polymyalgia

A

30 second sit to stand

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13
Q

3 derm signs of dermatomyositis

A

hellitrope rash
gottrons sign
shawl sign

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14
Q

what is gottrons sign

A

red/purple plaques on the back of the fingers, elbows or knees

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15
Q

name some other signs of organ involvement you may see in polymyositis

A

ILD, dysphagia, myocarditis, raynauds

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16
Q

bloods to investigate polymyositis

A

creatine kinase (largely raised)
inflammatory markers
autoantibodies

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17
Q

myositis specific autoantibodies

A

anti-jo-1
ant-SRP

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18
Q

name some non-specific autoantibodies that may be positive in myositis

A

ANA, anti-RNP

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19
Q

what is used to localise muscle involvement in polymyositis

A

MRI

20
Q

what is a definitive test for polymyositis

A

muscle biopsy

21
Q

biopsy of polymyositis shows…

A

perivascular inflammation and muscle necrosis

22
Q

1st line management of polymyositis

A

prednisolone

23
Q

name 2 complications of polymyositis

A

increased risk of malignancy
anti-synthetase syndrome

24
Q

what is fibromyalgia

A

a neurosensory disorder characterised by chronic MSK pain

25
Q

what is the most common cause of MSK pain in women 22-50

A

fibromyalgia

26
Q

what can cause fibromyalgia to begin

A

emotional or physical trauma

27
Q

clinical presentation of fibromyalgia

A

persistent widespread pain
fatigue
headaches
anxiety, depression
non-cardiac chest pain

28
Q

how do we diagnose fibromyalgia

A

clinical diagnosis of exclusion

29
Q

management of fibromyalgia

A

graded exercise programme
CBT
accupuncture

30
Q

what is myasthenia gravis associated with

A

other autoimmune conditions: SLE, rheumatoid arthritis, thyrotoxicosis

31
Q

most common age of presentation of myasthenia gravis

A

60-70

32
Q

tumour associated with myasthenia gravis

A

thymic tumour

33
Q

what kind of reaction is myasthenia gravis

A

type 2 hypersensitivity

34
Q

clinical presentation of myasthenia gravis

A

insidious onset,
initial complaint involves ocular muscles
fatigue and progressive muscle weakness

35
Q

testing for myasthenia gravis

A

anti-AChR IgG in serum

36
Q

first line management of myasthenia gravis

A

anticholinesterases

37
Q

what is myonecrosis

A

necrotising soft tissue infection caused by the proliferation and spread of c.perfringens from a contaminated wound

38
Q

clinical presentation of myonecrosis

A

disproportionate muscle pain
oedema and skin discolouration (bronze-red/purple-black

39
Q

imaging of myonecrosis

A

shows a feathering pattern of the soft tissue

40
Q

management of myonecrosis

A

immediate surgical debridement and antibiotic therapy

41
Q

what is pyomyositis

A

acute intramuscular infection

42
Q

most common cause of pyomyositis

A

staph aureus

43
Q

name 3 risk factors for pyomyositis

A

PWIDs
DM
immunosuppressed

44
Q

clinical presentation of pyomyositis

A

fever
pain and swelling in the affected area (usually lower extremities)

45
Q

management of pyomyositis

A

surgical debridement and antibiotics

46
Q

give some viruses that can cause viral myositis

A

influenza, enterovirus, HIV, CMV

47
Q

clinical presentation of viral myositis

A

pain, tenderness and swelling of muscle
a few days after the onset of a fever

48
Q

bloods in viral myositis

A

elevated CK

49
Q

what causes tetanus

A

c.tetani toxin

musculoskeletal (30 decks)

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