Rheumatology

Question 1

Characteristic features of polymyalgia rheumatica:

Answer 1

• Bilateral aching, tenderness and morning stiffness in shoulders, hips and proximal limb muscles
• Fatigue
• Fever
• Weight and appetite loss
• Depression
• Sometimes associated polyarthritis, tenosynovitis and/or carpal tunnel
• Raised ESR and CRP but normal creatinine kinase

Question 2

What is the management for polymyalgia rheumatica?

Answer 2

Prednisolone

Question 3

Classic presentation of Sjögren’s syndrome:

Answer 3

• Fatigue
• Dry eyes
• Dry mouth
• Associated auto-immune condition

Question 4

What is Schirmer’s test?

Answer 4

A test to measure rate of tear production. A piece of filter paper is placed in the lower conjunctival sac. The test is positive if less than 5 mm of paper is wetted after 5 minutes.

Positive in Sjögren’s syndrome