Muscle diseases

Question 1

what is polymyositis

Answer 1

idiopathic inflammatory myopathy

Question 2

are females or males more likely to get polymyositis

Answer 2

females

Question 3

what age group of females are most likely to get polymyositis

Answer 3

40-50

Question 4

what is dermatomyositis

Answer 4

polymyositis + skin involvement

Question 5

how does the skin present in dermatomyositis (3)

Answer 5

shawl sign/v shaped rash 
heliotrope rash (red/violet rash on eyelids) 
gottrons papules (scaly erythematous lesions on knuckles)

Question 6

where do gottrons papules present in dermatomyositis

Answer 6

knuckles

Question 7

where does a heliotrope rash present in dermatomysitis

Answer 7

eyelids/face

Question 8

presentation of polymyositis (4)

Answer 8

muscle weakness (progressive) in proximal, large muscles
symmetrical
weight loss
myalgia (muscle pain)
difficulty climbing stairs, brushing hair etc

Question 9

investigations for polymyositis

Answer 9

muscle biopsy 
EMG 
CK raised 
inflammatory markers raised 
autoantibodies

Question 10

gold standard investigation for polymyositis

Answer 10

muscle biopsy

Question 11

autoantibodies in polymyositis

Answer 11

ANA

anti-jo1

Question 12

treatment of polymyositis

Answer 12

steroid - prednisolone 40mg

immunosuppressant - methotrexate, anti-TNF

Question 13

complications of polymyositis

Answer 13

increased risk of malignancy

Question 14

what is inclusion body myositis

Answer 14

similar to polymyositis but not as much inflammation

Question 15

where does inclusion body myositis present (2)

Answer 15

distal muscles eg wrists, hands

asymmetrical

Question 16

prognosis of polymyositis

Answer 16

good if treated

Question 17

what is the treatment of dermatomyositis

Answer 17

same as polymyositis
steroids - prednisolone 40mg
immunosuppressant - methotrexate

Question 18

which group of people is inclusion body myositis common in (gender and age)

Answer 18

men >50

Question 19

what is the treatment of inclusion body myositis

Answer 19

same as polymyositis
steroids - prednisolone 40mg
immunosuppressant - methotrexate

Question 20

what is polymyalgia rheumatica

Answer 20

idiopathic, inflammatory myopathy

Question 21

which rheumatological condition is polymyalgia rheumatica associated with

Answer 21

giant cell arteritis

Question 22

is there muscle weakness in polymyalgia rheumatica

Answer 22

no

Question 23

presentation of polymyalgia rheumatica

Answer 23

NO muscle weakness
ache in shoulder/hip
morning stiffness >1 hour

Question 24

how long does morning stiffness last in polymyalgia rheumatica

Answer 24

> 1 hour

Question 25

what mental health issue is associated with polymyalgia rheumatica

Answer 25

anorexia

Question 26

what is the only abnormal investigation in polymyalgia rheumatica

Answer 26

inflammatory markers - CRP, PV

Question 27

what are the general investigations for muscle disease

Answer 27

muscle biopsy inflammatory markers - CRP, PV CK muscle power test

Question 28

which investigations are normal in polymyalgia rheumatic

Answer 28

muscle power muscle biopsy CK

Question 29

is there inflammation in polymyalgia rheumatica

Answer 29

no

Question 30

treatment of polymyalgia rhuematica

Answer 30

steroids - prednisolone 15mg (reduce over 2 years)

Question 31

is polymyalgia rheumatica curable

Answer 31

yes

Question 32

how long does it take to cure polymyalgia rhuematica

Answer 32

2 years

Question 33

what supplements do you need to give when treating polymyalgia rheumatica with steroids (3) why

Answer 33

Ca bisphosphonate Vit D osteoporosis prevention

Question 34

what is fibromyalgia

Answer 34

idiopathic non inflammatory muscle pain 'nothing is wrong with them'

Question 35

what GI condition is fibromyalgia associated with

Answer 35

IBS

Question 36

is fibromyalgia common

Answer 36

yes - 5% of population

Question 37

which group of people is fibromyalgia most common in

Answer 37

young women

Question 38

what mental health issue is fibromyalgia associated with

Answer 38

depression

Question 39

presentation of fibromyalgia (6 + location)

Answer 39

``` general aches and pains (esp neck, shoulder, lower back) soft tissue tenderness fatigue depression abdo pain (IBS) headaches/migraines ```

Question 40

examination in fibromyalgia

Answer 40

18 fibromyalgia tender points

Question 41

diagnosis of fibromyalgia

Answer 41

history and 11/18 fibromyalgia tender points

Question 42

what tests are normal in fibromyalgia

Answer 42

all inflammatory markers muscle biopsy antibodies muscle power test CK

Question 43

treatment of fibromyalgia (4)

Answer 43

nothing patient education - no cure pain relief - gabapentin anti depressants acupuncture

Question 44

what is the same about polymyositis and polymyalgia rheumatica

Answer 44

idiopathic inflammatory myopathy

Question 45

what is different about polymyositis and polymyalgia rheumatica

Answer 45

no muscle weakness in polymyalgia rheumatica but there is muscle weakness in polymyosits