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Y2 MSK > Muscle Diseases > Flashcards

Muscle Diseases Flashcards

1
Q

What is the difference between polymyositis and dermatomyositis?

A

Dermatomyositis = polymyositis + skin changes

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2
Q

The risk of malignancy increases with polymyositis and dermatomyositis. True/False?

A

True

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3
Q

List the classic presenting MSK features of poly/dermato -myositis

A

Proximal muscle weakness that worsens over months
Symmetrically affected
Myalgia
Difficulty with daily tasks

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4
Q

List investigations for poly/dermato -myositis

A 
Inflammatory markers
Muscle enzyme (CK)
Autoantibodies
Electrolytes
Electromyography
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5
Q

Which antibodies are associated with poly/dermato -myositis?

A

ANA

Anti-Jo-1

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6
Q

What is the definitive test for poly/dermato -myositis?

A

Muscle biopsy

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7
Q

List the main treatment for poly/dermato -myositis

A

Steroids
Immunosuppression (methotrexate, azathioprine)
Ciclosporin
Rituximab

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8
Q

What is the steroid usually used for poly/dermato -myositis?

A

Prednisolone 40mg daily

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9
Q

Inclusion body myositis is more common in males. True/False?

A

True

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10
Q

How would the msucle weakness be described in inclusion body myositis?

A

Asymmetrical distal muscle weakness

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11
Q

CK levels in inclusion body myositis are increased to a lesser fold compared to poly/dermato -myositis. True/False?

A

True

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12
Q

Inclusion body myositis is associated with anti-Jo-1 antibody. True/False?

A

False

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13
Q

Polymyalgia rheumatica is associated with which arteritic disease?

A

Giant cell arteritis

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14
Q

Muscle weakness if a feature of polymyalgia rheumatica. True/False?

A

False

Muscle pain and stiffness

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15
Q

List the common features of polymyalgia rheumatica

A

Morning stiffness - can’t get out of bed (>1 hour)
Improvement with movement/throughout the day
Hip and shoulder pain
Fatigue
Anorexia
Reduced movement

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16
Q

What is the mainstay of treatment for polymyalgia rheumatica?

A

Low dose steroid - usually rapid/dramatic response

17
Q

What is the commonest cause of chronic MSK pain?

A

Fibromyalgia

18
Q

Is fibromyalgia inflammatory?

A

No

19
Q

List some clinical features of fibromyalgia

A 
Broken sleep
Pain all over body (> 3 months)
Pins and needles
Headaches
Depression
Tenderness on soft tissues
Fatigue
20
Q

The aetiology of polymyalgia rheumatica (PMR) is unknown. True/False?

A

True

21
Q

What is the most common form of systemic vasculitis in adults?

A

Giant cell arteritis

22
Q

List clinical features of GCA

A 
Jaw claudication
Visual disturbance
Headache
Tender scalp
Non-pulsatile arteries
Systemic features
23
Q

What is the definitive test for diagnosing GCA?

A

Temporal artery biopsy

24
Q

Polymyositis is more common in men. True/False?

A

False

Women 2:1 men

25
Q

By how much is CK usually raised in polymyositis?

A

10x

26
Q

What is the definitive diagnostic test for polymyositis?

A

Muscle biopsy

27
Q

List some cutaneous features of dermatomyositis

A 
Heliotrope rash (puffy eyes)
Gottron's papules (violet patches on hands)
Shawl sign (V-shaped violet rash over chest)
28
Q

In which group of people is fibromyalgia most common in?

A

Young and middle-aged women

29
Q

What drugs may be given in fibromyalgia?

A

Amitryptilline (TCAD)
Gabapentin/ pregabalin (anticonvulsants)
Simple analgesia

30
Q

List the two main multi-organ features seen in polymyositis, and are indicators of poor prognosis?

A

ILD

Dysphagia

31
Q

What investigations are used in PMR?

A

ESR, PV, CRP (increased)

Temporal artery biopsy

32
Q

What is the steroid usually used for PMR? How does the dose change if GCA is suspected?

A

15mg Prednisolone

40mg if GCA

33
Q

What is the mainstay of treatment in fibromyalgia?

A

The mainstay of treatment for fibromyalgia is education and CBT, and graded exercise

34
Q

What are the features found on examination in fibromyalgia?

A

Excessive tenderness on palpation of soft tissues (11/18 points)

35
Q

What investigations are used in fibromyalgia?

A

No tests - diagnosis of exclusion

Inflammatory markers normal

Y2 MSK (30 decks)

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