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
what is the treatment of fibromyalgia
self-management techniques atypical analgesia psychological input
26
what types of atypical analgesias could be used in the treatment of fibromyalgia
tricyclic e.g. amitriptyline gabapentin pregabalin
27
what is myasthenia gravis
severe muscle weakness and progressive fatigue
28
what type of hypersensitivity is myasthenia gravis
type II hypersensitivity
29
when may symptoms first appear
during pregnancy, postpartum or while under anaesthetic
30
what are the symptoms of myasthenia gravis
fatigue progressive muscle weakness 60% of initial symptoms involve ocular muscles
31
what is the treatment of myasthenia gravis
anti-cholinestrase agents immunosuppressive drugs eculizumab
32
what immunosuppressive drugs could be used in the treatment of myasthenia gravis
corticosteroids | IVIg