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MS > Myositis > Flashcards

Myositis Flashcards

0
Q

myositis is NOT to be confused with

A

myopathy

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1
Q

categories of myositis/myopathies

A

1) myositis
2) rhabdo
3) drug-induced myopathy
4) metabolic myopathy

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2
Q

different types of mypotis

A

polymyositis
dermatomyositis
inclusion body myositis

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3
Q

criteria for myositis

A

symmetrical weakness of limb-girdle muscles and anterior flexors

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4
Q

what do we typically measure for suspected myositis

A

CPK
aldolase
AST, ALT
LDH

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5
Q

what increases CPK

A 
acute muscle injury
trauma
exercise
drugs
benign hyperCPKemia
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6
Q

EMG findings in myositis

A

short, small, polyphasia motor units
fibrillations with SHARP waves
bizarre, repetitive discharges

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7
Q

gender and myositises

A

F>M in DM/P

M>F for IBM

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8
Q

progression of myositis

A

slow, fixed proximal muscle weakness

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9
Q

by fixed we mean

A

weak ALL THE TIME, but also have fatigue, post-exertion aches, and pains

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10
Q

why is there an increased risk of malignancy?

A

secondary to myositis or if myositis is a paraneoplastic syndrome

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11
Q

other things you may see with myositis

A

raynauds
arthritis
pitting edema of extremities
pulmonary involvement

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12
Q

CDs in polymyositis

A

CD8>CD4

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13
Q

how to dx polymyositis (4)

A

prox muslce weakness
increased muscle enzymes
abnormal EMG
abnormal muscle bx

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14
Q

muslce atrorphy in polymyo

A

sparred until the very late in dz

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15
Q

what muscles are spared in polymyo

A

ocular and facial

16
Q

other things yo may see in poly

A

dysphagia (pharyngeal muslce weakness)
raynauds
SOB (resp muscles) (+ILD –>dyspnea, cough, hypoxemia)

17
Q

30% of patients exhibit

A

autoantibody to histidyltransfer RNA synthetase (Jo-1 antigen)

18
Q

tx polymyo

A

prednisone

if needed- MTX and azathioprine

19
Q

dermatomyositis pathophys

A

humoral ( b cells + CD4>CD8 t cells)–> inflammation in perifasicular and perivascular areas–> muscle fibeer necrosis and degen

*likely to be a paraneoplastic syndrome

20
Q

skin finds in dermatomyo

A

-violaceous with scaly desquamation–>occur in sun exposed areas (malar, chest shawl sign), extensor surfaces of elbows and knees, knucles (Gottron’s papules and Gottron’s sign), helicotrorpe

21
Q

other finding in dermatomyo

A

dilated nailfold capillaries

22
Q

juvenile dermatomyositis is adult form +

A

vasculitis
lipodystrophy
calcinosis

23
Q

amyopathic dermatomyositis

A

typical dermatomyo, but NO MUSCLE WEAKNESS

24
Q

anti-synthetase syndrome

A

PM or DM associated with anti-Jo-1 antbody

–strong association with ILD–also associated with Raynaud’s, arthritis, mechanic’s hands

25
Q

characteristics of inclusion body myositis

A

inflammatory myopathy with neuropathic features, causing paresthesias (tingling) and early involvement of distal muscles

26
Q

who does IBM usually affect?

A

middle-aged men–slowly progressive non-painful proximal myopathy w/ no response to treatment and progresses until it kills them

27
Q

what type of drugs induce drug-induced myopathy?

A

statin induced myopathy

-steroid-induced myopathy

28
Q

statin-induced myopathy

A

rare, but we use statins a lot so we see it–can be used with any dose and can occur at anytime
–>relieved by stopping, but sometimes need steroids

29
Q

steroid induced myopathy

A

common, occurs with any dose of steroids

proximal muscle weakness, w/o tenderness and atrophy, normal CPK

30
Q

bx of steroid induced myopathy shows

A

no inflammation

31
Q

polymyalgia rheumatica

A

does NOT involve musles–inflam of soft tissue

32
Q

polymyalgia rheumatic clinical presentation

A

acute onset of morning stiffness and pain esp at shoulder and hip girdle + muscle and joint pain, fatigue
maybe weight loss, depression, fever
**NO MUSCLE WEAKNESS

33
Q

labs in PR

A

increase ESR

normochromic normocytic anemia

34
Q

EMG in PR

A

normal@

35
Q

tx of PR

A

daily lose dose steroids-resolves within 24 hours

36
Q

metabolic myopathy symptoms

A

exercise intolerance secondary to cramps or weakness

myoglobin breakdown

37
Q

primary metabolic myopathy

A

abnormal glycogen
lipid, purine metabolism
mitochondrial abnormality

38
Q

secondary metabolic myopathy

A 
endocrine disorder
electrolyte disorder
uremia
liver failure
vit d/e def

MS (19 decks)

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