some stuff that is apparently MSK Flashcards
Fibromyalgia, sclerosis, and vasculitis.
risk factors for fibromyalgia
female (6:1) middle age low household income divorce low educational status
signs of fibromyalgia
low mood
poor concentration
symptoms of fibromyalgia
chronic fatigue
widespread pain
paraesthesia
which diseases is fibromyalgia associated with?
Chronic fatigue syndrome
IBS
SLE
diagnosis of fibromyalgia
clinical diagnosis
diagnosis of exclusion
treatment of fibromyalgia
long term graded exercise programme
low dose amitriptyline
SSRIs
CBT
risk factors for systemic sclerosis
genetic/family history infectious agents chemicals drugs radiation therapy physical trauma vitamin D deficiency
name some infections that can be a risk factor for systemic sclerosis
cytomegalovirus parvovirus B19 H. pylori hepatitis B EBV
pathology of systemic sclerosis
excessive collagen production
vascular damage
immune activation via autoantibody production and cell-mediated autoimmune mechanisms
which antibodies are implicated in systemic sclerosis?
anti-topoisomerase 1
anti-centromere antibody
anti-RNA polymerase III antibody
signs of LcSSC (limited cutaneous systemic sclerosis)
sclerodactyly long history of Raynaud's less skin involvement slow onset and progression symptoms may be unnoticed until internal complications occur
signs of dcSSc (diffuse cutaneous systemic sclerosis)
proximal scleroderma and trunk involvement rapid onset skin thickening Raynaud's phenomenon symptoms worse in first 3-5 years internal organ involvement
complications of systemic sclerosis
malignancy Sjogren's depression osteoporosis (due to reduced blood flow) hypothyroidism calcium deposits in fingers (due to scleroderma)
diagnosis of systemic sclerosis
bloods - CRP, ESR, FBC, renal function
autoantibodies
imaging
urinalysis (proteins)
treatment of systemic sclerosis
physiotherapy
immunotherapy
symptomatic relief
what is effected in systemic sclerosis?
all connective tissue
risk factors for vasculitis
minor trauma in vascular areas with depositions
definition of vasculitis
inflammation and necrosis of blood vessel walls with subsequent impaired blood flow
which antibodies are implicated in small/medium vessel vasculitis?
cytoplasmic anti-neutrophil cytoplasmic antibodies (c-ANCA)
peri-nuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)
pathology of vasculitis
vessel wall infiltration by neutrophils and mononuclear cells and fibronecrosis
deposition of immune complexes in vessel walls
give some examples of primary small vessel vasculitis
granulomatosis with polyangiitis (GPA)
Churg-Strauss
microscopic polyangiitis
sign of acute vasculitis
skin rash
signs of giant cell arteritis
headache
jaw claudication
scalp tenderness
blindness
signs of GPA
lung cavities
eye problems
saddle-nose deformity
diagnosis of giant cell arteritis
temporal artery biopsy
complications of vasculitis
thrombosis –> ischaemia/infarction
often skin and glomeruli
treatment of vasculitis
steroids cytotoxic drugs (cyclophosphamide)
