Rheumatic Diseases/Fibromyalgia

Question 1

continuous severe pain out of proportion to the injury and worsening over time

Answer 1

complex regional pain syndrome

Question 2

stages of CRPS

Answer 2

1: 1-3 mo, pain, stiffness, hair growth, skin changes
2: 3-6 mo, more pain, swelling, decreased hair growth, nail changes, osteomalacia, hypotonia
3: >6 mo, skin and bone changes irreversible, extreme pain, atrophy, joint deformity

Question 3

3 types of Juvenile Rh Arthritis

Answer 3

*Pauciarticular (4 or less joints)
Polyarticular (5 or more joints)
Systemic/Still’s disease (inflammation outside joints, w/ fever and rash)
**associated w/ iridocyclitis

Question 4

progression of ankylosing spondylitis

Answer 4

inflammation –> erosion –> healing –> bony fusion of fibrous ligaments

Question 5

what population is most commonly diagnosed with Systemic Lupus Erythematosus

Answer 5

women of childbearing age

Question 6

most mortality due to SLE is due to what

Answer 6

Renal failure

Question 7

What is SLE

Answer 7

an autoimmune connective tissue disorder that is chronic with cyclic exacerbations and remissions, presents like RA plus other issues

Question 8

inflammation, degeneration, and fibrosis of the skin, vasculature, joints, tendons, muscles, GI tract, lung, heart, and kidney

Answer 8

scleroderma

Question 9

what is a diagnostic sign of gout

Answer 9

deposition of monosodium rate (MSU) crystals, usually in the 1st MTP

Question 10

what are the 4 possible causes of gout

Answer 10

alcoholism, renal insufficiency, aspirin/diuretic usage, enzymatic abnormalities

Question 11

what is polymyalgia rheumatica

Answer 11

systemic inflammatory disease in those >50, characterized by systemic issues, and chronic symmetrical aching of proximal muscles and joints, especially in neck, shoulders, and pelvis

Question 12

How to treat polymyalgia rheumatica?

Answer 12

corticostreoids – usually allows for prompt recovery

Question 13

child-hood onset chronic pain syndrome

Answer 13

Amplified Musculoskeletal Pain Syndrome (AMPS)

Question 14

hallmarks of AMPS

Answer 14

increasing pain over time, heightened pain intensity, absence of other causes
usually adolescent girls, ages 12-13 of higher socioeconomic class w/ the presence of psychological distress

Question 15

hallmarks of fibromyalgia

Answer 15

widespread pain over 3 months with tender points all over the body

Question 16

New diagnosis criteria by American College of Rheumatology

Answer 16

I: Widespread pain index 0-19
II: Symtom severity – for fatigue, waking unrefreshed, and cognitive symptoms 0-3, and other symptoms 0-3
WPI of 7, SS of 5 OR WPI of 3-6, SS of 9, presence of symptoms for 3 months

Question 17

Fibromyalgia shows complications in what systems, and how for each

Answer 17

musculoskeletal – abnormalities in muscle fibers and muscle energy metabolism
endocrine – imbalance of hormones like cortisol and elevated immune markers
CNS – altered endogenous opioid activity and NT/neuropeptides

Question 18

abnormality in the Hypothalamas-Pituitary-Adrenal axis causes what?

Answer 18

fatigue and sleep disturbance