other Flashcards
what is polymyalgia rheumatica, who does it affect
a common, chronic inflammatory condition of unknown cause that affects elderly people (>50)
what are the symptoms of polymyalgia rheumatica
pain in proximal hip and shoulder girdles
morning stiffness >1hr, improves as the day goes on
15% of patients develop GCA
what are the investigations of polymyalgia rheumatica
no specific investigations
CRP & PV will be raised
responds immediately to treatment
what is the treatment of polymyalgia rheumatica
low dose steroids (15mg oral prednisolone), dose is gradually reduced over 18 months
what is polymyositis
idiopathic inflammatory myopathy that causes symmetrical, proximal muscle weakness
who is affected by polymyositis
women over 20, usually 45-50
what are the symptoms of polymyositis
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
what are the investigations of polymyositis, what would you expect to find
raised inflammatory markers autoantibodies MRI = localises the extent of muscle involvement EMG muscle biopsy = exclude other diseases confrontational testing isotonic testing
what are the auto-antibodies involved in polymyositis, which one is specific to this disease
ANA
Anti-jo-1 = specific
Anti-SRP
what is the treatment of polymyositis
40mg prednisolone + immunosuppressive drug
give examples of immunosuppressive drugs used to treat polymyositis
methotrexate azathioprine ciclosporin IV immunoglobin rituximab
what is dermatomyositis
similar to polymyositis but has additional cutaneous features
who is affected by dermatomyositis
women over 20, usually 40-50
what are the symptoms of dermatomyositis
V-shaped rash over the chest Gottron's papules heliotrope rash shawl sign ILD dysphagia myocarditis
where does a heliotrope rash appear
across the face including the eyelids
what is the investigations for dermatomyositis
aised inflammatory markers autoantibodies MRI = localises the extent of muscle involvement EMG muscle biopsy = exclude other diseases confrontational testing isotonic testing
what is the treatment for dermatomyositis
40mg prednisolone + immunosuppressive drug
what auto-antibodies are associated with dermatomyositis, which one is specific
ANA
Anti-jo-1 = specific
Anti-SRP
what diseases is Anti-jo-1 specific to
dermatomyositis
polymyositis
what is the most common MSK condition in young and middle aged women
fibromyalgia
what is fibromyalgia
unexplained condition causing widespread muscle pain and fatigue
what are the symptoms of fibromyalgia
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
what conditions is fibromyalgia associated with
IBS
migrane
anxiety
depression
what are the investigations of fibromyalgia
no specific investigations, diagnosis of exclusion + clinical picture
what is the treatment of fibromyalgia
self-management techniques
atypical analgesia
psychological input
what types of atypical analgesias could be used in the treatment of fibromyalgia
tricyclic e.g. amitriptyline
gabapentin
pregabalin
what is myasthenia gravis
severe muscle weakness and progressive fatigue
what type of hypersensitivity is myasthenia gravis
type II hypersensitivity
when may symptoms first appear
during pregnancy, postpartum or while under anaesthetic
what are the symptoms of myasthenia gravis
fatigue
progressive muscle weakness
60% of initial symptoms involve ocular muscles
what is the treatment of myasthenia gravis
anti-cholinestrase agents
immunosuppressive drugs
eculizumab
what immunosuppressive drugs could be used in the treatment of myasthenia gravis
corticosteroids
IVIg
