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19 Cards in this Set
- Front
- Back
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Signs of Dermatomyositis
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- Gottron's papules
- mechanic's hands - shawl sign - heliotrope rash - Periungual Telangiectasias |
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What is "shawl sign"
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Poikilodermatous macules in a shawl distribution, over the shoulders, arms and upper back.
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What is Poikilodermatous?
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Poikilodermatous is pigmentary and atrophic changes in the skin giving it a mottles appearance
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Fibromyalgia - how many trigger points
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18
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Fibromyalgia - how many trigger points needed for diagnosis
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11
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Fibromyalgia - how is it like polymyalgia rheumatica?
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Both are forms of soft tissue rheumatism or diffuse pain syndrome
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Fibromyalgia - why is it considered an affective disorder?
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Most patients have a history of anxiety, panic disorder, depression and/or disordered, non-refreshing sleep
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Fibromyalgia - what are its clinical features?
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- widespread pain, esp. in muscles and tendons of axial areas --> neck, trapezius, lower back, upper buttocks
- pain exacerbated by stress - chronic fatigue - morning stiffness - associated sx: tension h/a, IBS, sicca syndrome, urinary freq/urg, sensation of swollen hands |
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Fibromyalgia - what is its epidemiology?
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- more women
- middle age onset - across races, ethnic groups |
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Fibromyalgia - what is its pathophysiology?
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- unknown
- maybe CNS mechanism rather than aberration of muscle & tendon |
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Fibromyalgia - what are precipitating events?
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- infectious illness
- physical or emotional stress |
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Fibromyalgia - what neurotransmitter is increased in CSF?
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- Substance P, a neurotransmitter specific for pain transmission in the dorsal horn of the spinal column
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Fibromyalgia - where is decreased blood flow found?
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- thalamus: deep-brain relay station for all sensory input (pain and other), except olfaction.
- caudate nucleus - accompanying lower pain thresholds |
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Fibromyalgia - what stage sleep is interrupted?
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- stage 3-4 interrupted by alpha wave intrusion, leading to non-refreshing sleep and chronic fatigue
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Fibromyalgia - how do you diagnosis it?
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- Clinically. No diag labs
- Widespread pain > 3 mos - 11 of 18 trigger points - xrays & blood work to r/o hypothyroidism, SLE, osteo/RA |
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Fibromyalgia - what is treatment?
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- no steroids
- stretch, low stress aerobics - muscle relaxant, Flexeril - TCA's, e.g., Elavil - SSRI's, e.g., Prozac - low dose TCA + SSRI |
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Gout - what kind of disease is it?
- what causes it? |
- Metabolic
- hyperuricemia (too much uric acid in the blood) which has musculoskeletal consequences |
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Gout - where does uric acid come from
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- breakdown of purines: adenosine and guanosine
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Gout - what is the sodium salt of uric acid and what is its max solubility?
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- Monosodium urate
- 6.5 mg/dl of plasma |
