Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med MSK: > Rheumatologic conditions > Flashcards

Rheumatologic conditions Flashcards

1
Q

Who does CFS primarily affect

A

F>M
average age: 29-35
occurs more frequently among minority populations and those with a lower social-economical status and education level are at a higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the pathophysiology of CFS

A

unclear underling pathophysiology - diagnosis of exclusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is fatigue

A

described as weakness, tiredness and lethargy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the clinically concerning factors of fatigue

A

difficulty initiating activities
difficulty completing activities
memory and concentration difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is CFS diagnosed

A

with exclusion criteria - there are no objective physical exam findings.

requires 6 months of fatigue and all self reported symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are we ruling out when trying to determine CFS

A

ruling out medical or psychiatric conditions that might be causing fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the treatment of choice for CFS

A

cognitive behavioral therapy and graded exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is cognitive behavioral therapy (CBT)

A

psychotherapy technique aimed at changing throught/behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is Graded exercise therapy (GET)

A

home exercise program to improve conditioning and exercise tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are alternative treatment options for CFS

A

remaining active, physically and socially.
treat any co-occurring anxiety or affective disorders (common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is typically unhelpful in CFS treatment

A

medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the common patient presentation of fibromyalgia

A

affects 3-10% of the population
F>M
average age: 20-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the pathophysiology of Fibromyalgia

A

underling pathophysiology unknown
? abnormal pain perception, ? related to sleep disorder, ? depression, ? viral infectious etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the typically fibromyalgia presentation

A

MSK pain and impairment in functioning

chronic, achy pain and stiffness that usually involves the neck, shoulder, low back and hips

associated with
fatigue, sleep disturbances, subjective numbness, headache, IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How many tigger pints to diagnose fibromyalgia

A

11 of the 18 trigger points PLUS widespread chronic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is fibromyalgia diagnosed

A

symptoms for more than 3 months
there is no specific imaging or lab testing

rule out: amemia, thyroid abnormalities, electrolyte abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the 5 approaches to the treatment of fibromyalgia

A
  1. patient education
  2. non-pharmacologic options
  3. pharmacologic options
  4. treat any co-morbid conditions
  5. identify any available community resouces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what falls under patient education for fibromyalgia treatment

A

treatments can improve the symptoms, disease is not progressive, ID most distressing symptoms, Set treatment expectations (not complete relief of symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what falls under non-pharmacologic options for the treatment of fibromyalgia

A

mindfullness and meditation, exercise, sleep hygiene

managing their pain and function

20
Q

What are the pharmacologic options for treating fibromyalgia

A

amitriptyline for sleep, fatigue, and chronic pain
gabapentin/pregabalin for pain
muscle relaxants with one of the above for sleep and pain
tramadol and tylenol for pain

21
Q

what pharmacologic aids are unhelpful for fibromyalgia

A

NSAIDs and opioids

22
Q

What is polymyositis

A

chronic muscle inflammation and weakness

typically symmetric and proximal

23
Q

what is the typical patient presentation with polymyositis

A

F>M
average age: 50-60
african americans > caucasians

24
Q

what are patients diagnosed with polymyositis at an increased risk for

A

malignancy

25
Q

what is the typical presentation of polymyositis

A

progressive proximal muscle weakness that usually starts in the LE and moves to UE and neck

NO facial or ocular weakness but may include myocarditis, lung and joint involvement

26
Q

what can polymyositis be coupled with

A

a dermatomyositis - rash that is dusky red in color and commonly involves one or more of the following: face, upper chest, back, neck and shoulders

27
Q

what are other skin findings in dermatomyositis

A

heliotrope rash - periorbital edema and rash over eyelids
Gottron papules - raised violaceous lesions on extensor surfaces of DIP, PIP and MCP joints
Gotton sign - erythematous rash on the extensor surface of fingers, elbows and knees

28
Q

What is the most specific lab test for polymyositis

A

Creatinine kinase (CK) - elevated in all patients

29
Q

What is the gold standard for diagnosis of polymyositis

A

muscle biopsy - endomysial and perivascular inflammation

30
Q

What is the mainstay treatment for polymyositis

A

oral corticosteroids at a high dose (prednisone) and then taper down
if symptoms persist - MTX

hydroxychloroquine for the dermatomyositis rash and avoid the sun

31
Q

What is the patient population for polymyalgia rheumatica

A

disease of older adults - most common rheum disease diagnosed in older adults over 50
F>M
predilection for patients of scandinavian descent

32
Q

what is the pathophysiology of polymyalgia rheumatica

A

a vasculitis - inflammation of the vessel walls that predominately affects the medium sized vessels that is believed to be autoimmune

associated with HLA gene

33
Q

what is the presentation of PMR

A

muscular pain and stiffness that is typically present int he shoulder and pelvic girdle

NO MUSCLE WEAKNESS

often associated with fever, malaise and weight loss in the early presentation

34
Q

How is PMR diagnosed

A

primarily clinical and no imaging is necessary
labs can be supportive with elevated ESR, CPR and most patient have associated anemia

35
Q

how do we treat PMR

A

corticosteroids - low dose - should see affect within 72 hours - if not reconsider diagnosis

36
Q

What is giant cell arterities

A

also known as temporal arteritis
throught to be part of the same disease spectrum as PMR and is also a vasculitis but affects medium AND LARGE vessels

37
Q

What is associated with giant cell arterities

A

unclear association with varicella zoster antigen

38
Q

how does Giant cell arteritis present

A

headache, scalp tenderness, visual disturbances (amaurosis fugax), throat pain, JAW CLAUDICATION and associated fever

39
Q

what is Amaurosis fugax

A

sudden monocular vision loss, partial or complete
CURTAIN COMING DOWN - can lead to blindness

40
Q

What is the presentation of giant cell ateritis

A

temporal artery usually normal to palpation but nodular, enlarged, tender and pulseless

41
Q

what are patients with GCA at greater risk for

A

17x their risk of thoracic aortic aneurysm

42
Q

what is the gold standard for GCA

A

temporal artery biopsy

43
Q

how is GCA treated?

A

corticosteroids are first line (high dose)
but urgent biopsy necessary

if vision loss - IV methypred.

44
Q

What is the difference between Raynauds phenomenon and raynauds disease

A

raynauds phenomenon tends to be more severe and associated with CT diseases, unilateral (asymmetric), quicker progression, skin changes (ulcerations/gangrene), abnormal allens test

Raynauds disease is idiopathic and the more common form, symmetric bilaterally, slower progression, no skin changes, peripheral pulses present, negative allens test

45
Q

What is the progression of Raynauds

A

White, blue, red
Vasospasm - lack of blood flow (white)
lack of arterial flow - cyanosis (blue)
resolution of vasopasm and reprofusion - rebound hyperemia (Pink/red)

46
Q

What is the treatment for raynauds

A

lifestyle modifications
prevention of attacks, avoiding cold exposure, warm clothing, avoid smoking and vasoconstrictive drugs and injuries to your hands

Clin Med MSK: (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions