Rheumatology: Polymyositis & Dermatomyositis Flashcards Preview

Unit 4: Blood and Lymph > Rheumatology: Polymyositis & Dermatomyositis > Flashcards

Flashcards in Rheumatology: Polymyositis & Dermatomyositis Deck (25)
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1

Polymyositis (PM) and dermatomyositis (DM) are characterized by ______ and ______.

chronic muscle weakness; infiltration of muscle tissue by chronic inflammatory cells

2

In DM, the inflammatory muscle disease is accompanied by ____.

typical skin rashes

3

PM and DM occur in association with neoplastic disease or in “overlap” with other autoimmune diseases such
as _____, _____, _____, and _____.

scleroderma, mixed connective tissue disease (MCTD), Sjögren’s syndrome, SLE

4

_____ and _____ are typically the main complaints in patients with PM/DM.

Muscle weakness; low endurance

5

What is an erythematous papular rash over the metacarpal or interphalangeal joints called?

Gottron's papules

6

What are Gottron's papules called they occur over the elbows and knees?

Gottron's sign

7

Blue-purple discoloration of the upper eyelid

Heliotrope rash

8

What is V-sign?

Erythematous V-shape rash over the anterior chest

9

What is a shawl-sign rash?

an erythematous rash over the shoulders and upper back

10

What is cracked, dry-appearing skin over the finger pads, particularly on the radial side of the index fingers called?

mechanic's hands

11

What is Calcinosis cutis?

Subcutaneous calcification; occurs primarily in juvenile dermatomyositis

12

What are Gottron's papules?

Erythematous papular rash over the metacarpal or interphalangeal joints; can also occur over the elbows and knees (Gottron’s sign)

13

What is a Heliotrope rash?

Blue-purple discoloration of the upper eyelid

14

This is an erythematous V-shape rash over the anterior chest.

V-sign

15

This is an erythematous rash over the shoulders and upper back.

Shawl-sign rash

16

Periungual erythema, nail-fold telangiectasias, and cuticular overgrowth are more common in ___.

DM

17

What is Holster sign?

poikiloderma (atrophic mottled skin) on the lateral aspects of the thighs

18

What are the 7 extra-muscular manifestations of DM/PM?

1. Constitutional symptoms: Unintentional weight-loss, fever, fatigue.
2. Gastrointestinal: Dysphagia; intestinal perforation (caused by mesenteric vasculitis in juvenile DM)
3. Pulmonary: Interstitial lung disease (pulmonary fibrosis —50 to 60% in those with the anti-Jo-1 antibody; aspiration pneumonia.
4. Cardiac: Myocarditis; conduction defects; arrhythmias.
5. Musculoskeletal: Nonerosive inflammatory arthritis.
6. Vascular: Raynaud’s phenomenon; vasculitis (in juvenile DM)
7. Anti-synthetase Syndrome: Constellation associated with antisynthetase antibodies (e.g. anti-Jo-1 antibody): PM or DM presenting with fever (20%), arthritis (50%), mechanic’s hands (30%), Raynaud’s phenomenon (40%), and interstitial lung disease (ILD, 60%).

19

What is the epidemiology of DM/PM?

10 per million

20

What is the female:male ratio of DM/PM?

2-3:1

21

What is the peak age of incidence of DM/PM?

two: childhood and 5th decade

22

What race is predisposed to DM/PM?

African-Americans by 2-3 fold

23

____ will be elevated in the vast majority of patients with active DM/PM.

CPK

24

What indicators, other than CPK, can be used to check for muscle injury?

aldolase, myoglobinemia, LDH, AST, ALT

25

What are the 3 myositis-specific antibodies (MSAs)?

1. aminoacyl-tRNA synthetase antibodies
2. Anti-Mi-2 antibody
3. Anti-signal recognition particle (SRP) antibodies