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other Flashcards

1
Q

what is polymyalgia rheumatica, who does it affect

A

a common, chronic inflammatory condition of unknown cause that affects elderly people (>50)

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2
Q

what are the symptoms of polymyalgia rheumatica

A

pain in proximal hip and shoulder girdles
morning stiffness >1hr, improves as the day goes on
15% of patients develop GCA

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3
Q

what are the investigations of polymyalgia rheumatica

A

no specific investigations
CRP & PV will be raised
responds immediately to treatment

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4
Q

what is the treatment of polymyalgia rheumatica

A

low dose steroids (15mg oral prednisolone), dose is gradually reduced over 18 months

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5
Q

what is polymyositis

A

idiopathic inflammatory myopathy that causes symmetrical, proximal muscle weakness

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6
Q

who is affected by polymyositis

A

women over 20, usually 45-50

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7
Q

what are the symptoms of polymyositis

A 
muscle weakness in upper and lower extremities, insidious onset
muscle pain
dysphagia if oesophagus is involved
ILD in 5-30% of patients
strong association with malignancies
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8
Q

what are the investigations of polymyositis, what would you expect to find

A 
raised inflammatory markers
autoantibodies 
MRI = localises the extent of muscle involvement
EMG
muscle biopsy = exclude other diseases
confrontational testing
isotonic testing
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9
Q

what are the auto-antibodies involved in polymyositis, which one is specific to this disease

A

ANA
Anti-jo-1 = specific
Anti-SRP

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10
Q

what is the treatment of polymyositis

A

40mg prednisolone + immunosuppressive drug

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11
Q

give examples of immunosuppressive drugs used to treat polymyositis

A 
methotrexate
azathioprine
ciclosporin
IV immunoglobin 
rituximab
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12
Q

what is dermatomyositis

A

similar to polymyositis but has additional cutaneous features

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13
Q

who is affected by dermatomyositis

A

women over 20, usually 40-50

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14
Q

what are the symptoms of dermatomyositis

A 
V-shaped rash over the chest
Gottron's papules
heliotrope rash 
shawl sign
ILD
dysphagia
myocarditis
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15
Q

where does a heliotrope rash appear

A

across the face including the eyelids

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16
Q

what is the investigations for dermatomyositis

A 
aised inflammatory markers
autoantibodies 
MRI = localises the extent of muscle involvement
EMG
muscle biopsy = exclude other diseases
confrontational testing
isotonic testing
17
Q

what is the treatment for dermatomyositis

A

40mg prednisolone + immunosuppressive drug

18
Q

what auto-antibodies are associated with dermatomyositis, which one is specific

A

ANA
Anti-jo-1 = specific
Anti-SRP

19
Q

what diseases is Anti-jo-1 specific to

A

dermatomyositis

polymyositis

20
Q

what is the most common MSK condition in young and middle aged women

A

fibromyalgia

21
Q

what is fibromyalgia

A

unexplained condition causing widespread muscle pain and fatigue

22
Q

what are the symptoms of fibromyalgia

A 
persistent, widespread pain (>3 months) on both sides of body above and below waist
fatigue
disrupted and unfreshing sleep
cognitive difficulties
anxiety/depression
brain fog/memory impariment
23
Q

what conditions is fibromyalgia associated with

A

IBS
migrane
anxiety
depression

24
Q

what are the investigations of fibromyalgia

A

no specific investigations, diagnosis of exclusion + clinical picture

25
Q

what is the treatment of fibromyalgia

A

self-management techniques
atypical analgesia
psychological input

26
Q

what types of atypical analgesias could be used in the treatment of fibromyalgia

A

tricyclic e.g. amitriptyline
gabapentin
pregabalin

27
Q

what is myasthenia gravis

A

severe muscle weakness and progressive fatigue

28
Q

what type of hypersensitivity is myasthenia gravis

A

type II hypersensitivity

29
Q

when may symptoms first appear

A

during pregnancy, postpartum or while under anaesthetic

30
Q

what are the symptoms of myasthenia gravis

A

fatigue
progressive muscle weakness
60% of initial symptoms involve ocular muscles

31
Q

what is the treatment of myasthenia gravis

A

anti-cholinestrase agents
immunosuppressive drugs
eculizumab

32
Q

what immunosuppressive drugs could be used in the treatment of myasthenia gravis

A

corticosteroids

IVIg

MSK (mine) (17 decks)

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