older patient with pain Flashcards

1
Q

5 general parts to approach

A
  1. patient centered - experience
  2. does this fit a pattern?
  3. timing and progression
  4. red flags?
  5. priority - emergent vs. routine
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2
Q

DDx (5)

A
  1. polymyalgia rheumatica
  2. inflammatory arth (eg RA)
  3. fibro
  4. myositis
  5. malignancy/systemic/lupus
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3
Q

4 articular causes to consider

A
  1. inflammatory (RA)
  2. other seropositive (SLE, vasculitis)
  3. seroneg. spondylo
  4. OA
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4
Q

5 key findings in RA bloodwork

A
  1. RF
  2. normocytic anemia
  3. cytopenia
  4. mildly elevated ESR/CRP
  5. pos. anti-CCP
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5
Q

features of polymyalgia rheumatica

A
  • stiffness and pain in muscles of neck and shoulder girdle
  • failry rapid onset
  • unusual before 50
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6
Q

best test for polymyalgia

A

ESR - typically >40

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7
Q

what to assess in polymyalgia

A

check for GCA - 15% also have and can go on to dev. as well

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8
Q

featues of myositis

A
  • inflammatory
  • PAINLESS muscle weakness - esp proximal
  • some may also have general aches and stiffness
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9
Q

best test for myositis

A

CK

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10
Q

def. of fibro

A

chronic widespread pain accompanied by other somatic symptoms

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11
Q

best test for fibro

A

no test

- typically can be done with Hx and ruling out pertinent negatives

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12
Q

3 common fibro other Sx

A
  1. fatigue
  2. sleep probs
  3. cog. changes
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13
Q

treatment of polymyalgia rheum

A

prednisone

- can give rapid releif

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14
Q

how to take off

A

slow taper

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