Muscle diseases Flashcards

1
Q

what is polymyositis

A

idiopathic inflammatory myopathy

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2
Q

are females or males more likely to get polymyositis

A

females

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3
Q

what age group of females are most likely to get polymyositis

A

40-50

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4
Q

what is dermatomyositis

A

polymyositis + skin involvement

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5
Q

how does the skin present in dermatomyositis (3)

A
shawl sign/v shaped rash 
heliotrope rash (red/violet rash on eyelids) 
gottrons papules (scaly erythematous lesions on knuckles)
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6
Q

where do gottrons papules present in dermatomyositis

A

knuckles

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7
Q

where does a heliotrope rash present in dermatomysitis

A

eyelids/face

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8
Q

presentation of polymyositis (4)

A

muscle weakness (progressive) in proximal, large muscles
symmetrical
weight loss
myalgia (muscle pain)
difficulty climbing stairs, brushing hair etc

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9
Q

investigations for polymyositis

A
muscle biopsy 
EMG 
CK raised 
inflammatory markers raised 
autoantibodies
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10
Q

gold standard investigation for polymyositis

A

muscle biopsy

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11
Q

autoantibodies in polymyositis

A

ANA

anti-jo1

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12
Q

treatment of polymyositis

A

steroid - prednisolone 40mg

immunosuppressant - methotrexate, anti-TNF

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13
Q

complications of polymyositis

A

increased risk of malignancy

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14
Q

what is inclusion body myositis

A

similar to polymyositis but not as much inflammation

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15
Q

where does inclusion body myositis present (2)

A

distal muscles eg wrists, hands

asymmetrical

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16
Q

prognosis of polymyositis

A

good if treated

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17
Q

what is the treatment of dermatomyositis

A

same as polymyositis
steroids - prednisolone 40mg
immunosuppressant - methotrexate

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18
Q

which group of people is inclusion body myositis common in (gender and age)

A

men >50

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19
Q

what is the treatment of inclusion body myositis

A

same as polymyositis
steroids - prednisolone 40mg
immunosuppressant - methotrexate

20
Q

what is polymyalgia rheumatica

A

idiopathic, inflammatory myopathy

21
Q

which rheumatological condition is polymyalgia rheumatica associated with

A

giant cell arteritis

22
Q

is there muscle weakness in polymyalgia rheumatica

A

no

23
Q

presentation of polymyalgia rheumatica

A

NO muscle weakness
ache in shoulder/hip
morning stiffness >1 hour

24
Q

how long does morning stiffness last in polymyalgia rheumatica

A

> 1 hour

25
Q

what mental health issue is associated with polymyalgia rheumatica

A

anorexia

26
Q

what is the only abnormal investigation in polymyalgia rheumatica

A

inflammatory markers - CRP, PV

27
Q

what are the general investigations for muscle disease

A

muscle biopsy
inflammatory markers - CRP, PV
CK
muscle power test

28
Q

which investigations are normal in polymyalgia rheumatic

A

muscle power
muscle biopsy
CK

29
Q

is there inflammation in polymyalgia rheumatica

A

no

30
Q

treatment of polymyalgia rhuematica

A

steroids - prednisolone 15mg (reduce over 2 years)

31
Q

is polymyalgia rheumatica curable

A

yes

32
Q

how long does it take to cure polymyalgia rhuematica

A

2 years

33
Q

what supplements do you need to give when treating polymyalgia rheumatica with steroids (3)

why

A

Ca
bisphosphonate
Vit D

osteoporosis prevention

34
Q

what is fibromyalgia

A

idiopathic non inflammatory muscle pain

‘nothing is wrong with them’

35
Q

what GI condition is fibromyalgia associated with

A

IBS

36
Q

is fibromyalgia common

A

yes - 5% of population

37
Q

which group of people is fibromyalgia most common in

A

young women

38
Q

what mental health issue is fibromyalgia associated with

A

depression

39
Q

presentation of fibromyalgia (6 + location)

A
general aches and pains (esp neck, shoulder, lower back)
soft tissue tenderness 
fatigue 
depression 
abdo pain (IBS) 
headaches/migraines
40
Q

examination in fibromyalgia

A

18 fibromyalgia tender points

41
Q

diagnosis of fibromyalgia

A

history and 11/18 fibromyalgia tender points

42
Q

what tests are normal in fibromyalgia

A

all

inflammatory markers muscle biopsy
antibodies
muscle power test
CK

43
Q

treatment of fibromyalgia (4)

A

nothing

patient education - no cure
pain relief - gabapentin
anti depressants
acupuncture

44
Q

what is the same about polymyositis and polymyalgia rheumatica

A

idiopathic inflammatory myopathy

45
Q

what is different about polymyositis and polymyalgia rheumatica

A

no muscle weakness in polymyalgia rheumatica but there is muscle weakness in polymyosits