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MSK > Myositis > Flashcards

Myositis Flashcards

1
Q

What are the visual signs of dermatomyositis?

A

Gottrons sign
Heliotrope rash
Shawl sign

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2
Q

What other organ involvement can occur with dermatomyositis?

A

Lung - ILD
Oesophageal - Dysphagia
Cardiac - myocarditis - ventricular dysfunction

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3
Q

Name two tests which can be done to assess muscle weakness

A

Confrontational testing

Isotonic testing - 30 second sit to stand test

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4
Q

What will you be looking for in blood tests?

A

CK, Inflammatory markers, electrolytes, Calcium, PTH, TSH, autoantibodies (ANA, Anti Jo 1)

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5
Q

What is anti Jo 1 specific to?

A

Myositis

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6
Q

What other tests could be used in diagnosis of myositis?

A

EMG - muscle electrical conduction

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7
Q

What is the drug therapy for myositis?

A
  • Glucocorticoids
  • Azathioprine – immune suppressive
  • Methotrexate
  • Ciclosporin – immune suppressive – decrease in T cells
  • IV Ig
  • Rituximab – monoclonal antibody, against CD20, found primarily on B cells
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8
Q

What age group does Inclusion body myositis affect?

A

Over 50s

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9
Q

What is polymyalgia rheumatic associated with?

A

Temporal arteritis, giant cell arteritis

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10
Q

What age group does polymyalgia rheumatica affect?

A

Over 50s - DO NOT SEE IN YOUNG PEOPLE

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11
Q

What are the clinical manifestations of polymyalgia rheumatica?

A
  • Ache in shoulder and hip girdle
  • Morning stiffness
  • Usually symmetrical
  • Fatigue, anorexia, weight loss, fever
  • Normal muscle strength
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12
Q

What are the presenting features of temporal arteritis and giant cell arteritis?

A
  • Unilateral headache
  • Scalp tenderness
  • Jaw claudication
  • Visual loss
  • Tender, enlarged, non pulsatile temporal arteries
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13
Q

What blood tests are raised in temporal arteritis and giant cell arteritis?

A

ESR, plasma viscosity and CRP

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14
Q

What is the treatment for giant cell arteritis?

A

Low dose steroid - 15mg of prednisolone

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15
Q

What is the treatment for temporal arteritis?

A

40 -60 mg prednisolone

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16
Q

What are some of the symptoms of fibromyalgia?

A 
Tension headache
Weight fluctuations 
Night sweats 
ENT complaints - rhinitis 
Weakness 
Non cardiac chest pain
17
Q

How many out of 18 tender points makes it a positive diagnosis of fibromyalgia?

A

11

18
Q

Are the inflammatory markers raised in fibromyalgia?

A

No, its non inflammatory

19
Q

What is the management of fibromyalgia?

A 
Patient education 
CBT
Accupuncture 
Anti depressants 
Gabapentin - used to treat nerve pain

MSK (11 decks)

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