Myopathy

Question 1

What is the principle immune target of idiopathic inflammatory myopathies?

Answer 1

muscle tissue

Question 2

What is the difference between polymyositis and dermatomyositis?

Answer 2

• dermatomyositis is polymyositis with skin manifestations

* Polymyositis is anidiopathic diffuse autoimmune disease of skeletal muscle

Question 3

Idiopathic inflammatory myopathies results in _______ and _______ muscle weakness with an insidious onset.

Answer 3

proximal and symmetric

Question 4

Patients with idiopathic inflammatory myopathies are at an increased susceptibility to what?

Answer 4

cancer

Question 5

How do you distinguish a malar rash vs. heliotrope rash?

Answer 5

Helioptrope involves eyelids and nasolabial folds

Question 6

What serum muscle enzyme will be extremely high in idiopathic inflammatory myopathies?

Answer 6

creatine kinase (CK/CPK)

Question 7

What autoantibodies are associated with idiopathic inflammatory myopathies?

Answer 7

• anti-Jo-1 antibody

Question 8

In idiopathic inflammatory myopathies, elevations in _______ precede clinical exacerbations

Answer 8

serum enzymes

Question 9

What is the best confirmatory test for idiopathic inflammatory myopathies?

Answer 9

muscle biopsy

Question 10

What is the treatment for idiopathic inflammatory myopathies? (3 part)

Answer 10

• physical therapy
• corticosteroids (predinosone) 1 year taper
• immunosuppressants (methotrexate) started simultaneously

Question 11

In any patient with idiopathic inflammatory myopathies they must be screened for what?

Answer 11

occult malignancy

Question 12

What antibody is elevated in mixed connective tissue disease (MCTD)?

Answer 12

anti-U1 RNP (ribonucleoprotein antibodies)

Question 13

This is defined as a chronic functional somatic disorder resulting in widespread MSK pain.

Answer 13

fibromyalgia

Question 14

How is fibromyalgia diagnosed?

Answer 14

• Based on the 2010 ACR criteria
• widespread pain index (WPI) >7
• symptom severity scale (SSS) >5
• duration of at least 3 months
• no alternative diagnosis

Question 15

For an initial presentation of fibromyalgia what is the first line medication of choice?

Answer 15

amitriptyline (anti-depressant)

Question 16

Patients with fibromyalgia have the best prognosis when they are managed by this physician.

Answer 16

primary care clinicians