Rheumatology- Myopathy (fibromyalgia, myositis, etc.) & amyloidosis Flashcards
1
Q
Diagnosis: Patient with giant cell arteritis develops muscle weakness a few months after starting therapy
A
Glucocorticoid-induced myopathy
Mechanism: increased muscle catabolism and decreased anabolism
2
Q
Signs and symptoms of glucocorticoid-induced myopathy
A
- Painless proximal weakness
- Muscle atrophy
- Lower extremities affected first
- No inflammation or tenderness
- Normal CK and ESR
- High-pulse dose or long-term glucocorticoid use
3
Q
Signs and symptoms of polymyalgia rheumatica
A
Morning stiffness Muscle tenderness and pain ↓ ROM neck, shoulder, hip girdle Normal strength Normal CK, ↑ ESR
Rapid response to glucocorticoids
4
Q
S&S of inflammatory myopathies
A
Symmetric proximal weakness Muscle tenderness and pain Skin rash Inflammatory arthritis ↑ CK, ↑ ESR
5
Q
S&S of hypothyroid myopathy
A
Proximal cramps & weakness Muscle pain Delayed DTR Myoedema Rhabdomyolysis Normal ESR, ↑ CK Signs of hypothyroidism
6
Q
Dermatomyositis
A
Idiopathic inflammatory myopathy with immune-mediates muscle fiber injury
7
Q
S&S dermatomyositis
A
- Symmetrical Proximal muscle weakness
- Gottron Sign (erythematous rash on the dorsal of fingers)
- Heliotrope eruption (rash on upper eyelids)
- Polyarthritis
- Raynaud phenomenon
8
Q
Diagnosis of dermatomyositis
A
Confirmed by muscular biopsy
9
Q
Paraneoplastic syndromes causing muscle weakness
A
Dermatomyositis
Myasthenia gravis
LEMS
Paraneoplatic myelopathy of the spinal cord
10
Q
S&S secondary amyloidosis (AA)
A
Cardiomyopathy Nephrotic Syndrome Hepatomegaly Peripheral/ autonomic neuropathy Organ enlargement Waxy easy bruising skin
11
Q
Diagnosis secondary amyloidosis (AA)
A
Amyloid tissue on biopsy (fat pad biopsy) Renal biopsy ( amorphous hyalin deposits that stain with Congo red)
