Polymyositis and Sjogrens

Question 1

Polymyositis or dermatomyositis c/f

Answer 1

Female, 40-60yrs
1. Heliotrope violet rash over eyelid, forehead, cheek
2. Rash on back - SHAWL SIGN
3. GROTTON PAPULES - dorsal hand
4. Proximal muscle weakness - shoulder, pelvic girdle
5. Symmetrical arthralgia of hands and feet (like RA)
6. Muscle pain
7. Dysphagia - oesophagial invl
8. Raynauds
9.*Weakness main complaint

Question 2

Polymyositis or dermatomyositis a/w which carcinoma

Answer 2

Lung and Ovary CA

Question 3

Investigation for Polymyositis

Answer 3

Initial:
↑Sr creatine kinase
↑Aldolase

Best/Confirmatory:
Biopsy

Other:
EMG studies

Question 4

Rx for Polymyositis or dermatomyositis

Answer 4

Steroids and cytotoxic drugs
Refer

Question 5

Difference between polymyositis, Polymyalgia rheumatica (a/w GCA), drug induced myositis

Answer 5

Polymyositis:
1. Weakness of proximal muscles - main complaint
2. ↑CK
3. N - ESR, CRP

PMR:
1. Pain in proximal muscles - main complaint
2. N- CK
3. ↑↑ ESR, CRP

Drug induced myopathy: (steroids)
1. Weakness
2. N- CK
3. N- ESR, CRP

Question 6

Sjogrens c/f

Answer 6

Dryness - eyes, mouth,throat, vagina
Swelling of parotid gland
Dental caries
Non-erosive arthritis

Question 7

Sjogrens can tranform into which carcinoma

Answer 7

Non-Hodgkins lymphoma

Question 8

Investigations for Sjogrens

Answer 8

Initial:
RA, ANA
Anti Ro, La
Schirmers

Best/confirmatory:
Salivary gland biopsy - lymphocytic infiltration

Question 9

Mx of Sjogrens

Answer 9

Symptomatic

Flare ups - methotrexate
Arthritis, pains - steroids