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LOCO > 18 - Muscle in Health and Disease > Flashcards

18 - Muscle in Health and Disease Flashcards

1
Q

What percent of body mass should be muscle

A

40%

80% of water

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2
Q

Muscle function

A

Movement and strenght
Heat production
Glucose metabolism
Store for intracellular ions

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3
Q

Features of skeletal muscle

A

Striated
Multinucleated fibres
Peripheral nucleus

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4
Q

What is the significance of central nuclei in skeletal muscle

A

The muscle is going through repair

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5
Q

What is a motor unit

A

Functional unit of a group of muscle fibres that will all contract at the same time

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6
Q

What happens if loss of innervation in adult of single motor neuron

A

all muscle fibres innervated by that motor neuron are affected – muscle undergoes atrophy

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7
Q

What is infantile hypotonia

A

Floppy baby sydrome - baby with decreased tone which can be caused by many reasons

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8
Q

What would you look at if suspect a myopathic hypotonia

A

ATPase

Size of fibres

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9
Q

What is congenital fibre type disproportion

A

Disproportion in different types of fibres
t1 - large type 1 muscle fibres (aerobic) with t2 - small t2 muscle fibres (mixed)

can also have the opposite
Usually evens out

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10
Q

Sarcopenia

A

Muscle is lost and replaced by fat

More likely to have osteoporosis

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11
Q

percentage of muscle loss after the age of 50

A

0.5 - 1%

3-5% if physically inactive

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12
Q

What is the difference between polymyositis and dermatomyositis

A

They are the exact same however dermatomyositis includes skin involvement(rash)

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13
Q

What is dermatomyositis

A

An autoimmune condition causing proximal muscle weakness (hip and shoulders)

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14
Q

Biopsy of dermatomyositis pation

A

The outer part of the fascicle there is invasion of inflammatory cells (CD8 T lymphocytes)
Variation in fibre size
Central nuclei
Macrophages

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15
Q

Clinical features of dermatomyositis

A

Symmetrical

Serum creatinine kinase elevated

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16
Q

EMG of patient with dermatomyositis

A

Typically irritable in 90%
- looks like the muscle is always active
Fibrillations at rest + spontaneous activity

17
Q

What does the rash look like in dermatomyositis

A

Purple
Streaky pattern
Heliotrope rash over eyelids, cheek, back with oedema

18
Q

What is the autoantibody that is present in 20-40% of dermatomyositis cases

A

Anti-Jo1 antibody

Golgi apparatus antibody

19
Q

What does the Anti-Jo1 antibody cause

A

Subcutaneous calcification in muscles and in skin

20
Q

Treatment of dermatomyositis

A

Corticosteroids - maintained until creatinine kinase is normal (high dose prednisone)
Azathioprine
Methotrexate

21
Q

What is Inclusion body myositis

A

Inflammatory myopathy causing muscle weakness

22
Q

Which muscles affected in inclusion body myositis

A

Finger and wrist flexors
Knee extensors
Loss of quadriceps reflex
Dysphagia

23
Q

Biopsy of inclusion body myositis

A

Fibres contain empty vacuoles + clumps of cellular material that contain amyloid like material - stains with congo red

24
Q

What do the filamentous inclusion contain

A

Beta amyloid
Hyperphosphorylated tau
apolipprotein E
presenillin E

25
Q

What is duchenne syndrome

A

Complete loss of dystrophin

26
Q

What is becker syndrome

A

A milder form of duchennes

27
Q

What is dystrophins funciton

A

Acts as a shock absorber, prevents muscle fibres being damaged

28
Q

When does the symptoms of duchennes present

A

Proximal muscle weakness for up to 2 years
Continuous slow decline
Unable to walk by 7-12 years
Death mid 20s to 30s

29
Q

Creatine kinase levels in duchennes

A

Elevated massively

30
Q

Biopsy of duchennes

A

Fibre size variability
Endomysial fibrosis
Loss of muscle replaced with fibrotic material and fat

31
Q

What can long term corticosteroids do to muscle

A

type 2 fibre atrophy

32
Q

What can statins cause

A

rhabdomyolysis

33
Q

What is fibromyalgia

A

Pain in the fibrous tissue of muscle - widespread muscle pain

34
Q

Where does fibromyalgia occur in the body

A

Both sides of body

above and below the waist

35
Q

How do you diagnose fibromyalgia

A

Combination of 11 or more out of 18 tender points

36
Q

Cycle of fibromyalgia issues

A 
Pain 
Muscle tension
Daily stress
Limited activity 
Fatigue
Depression
Muscle stiffness
37
Q

Common groups with fibromyalgia

A

30-60 y/o

80-90% are female

38
Q

Treatment for fibromyalgia

A

Tricyclic depressants for sleep - amitriptyline
SSRIS also for sleep - fluoxetine
Exercise
Complementary therapy

LOCO (25 decks)

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