Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
What are the three steps to approaching a patient with generalized muscle weakness?
|
1. Distinguish as TRUE muscle weakness
2. Localize site of lesion 3. Determine cause |
|
|
How do you determine TRUE muscle weakness?
|
Formal muscle testing
|
|
|
How do you localize muscle lesion site?
|
EMG/NCV
|
|
|
List three Idiopathic Inflammatory Myopathies (IIM).
|
1. Polymyositis
2. Dermatomyositis 3. Juevenile DM/PM |
|
|
What population group is most likely at risk for PM/DM?
|
Black women
|
|
|
In caucasian patients, what are the genetic components associated with IIM? x3
|
HLA-DR3
HLA-DR6 HLA-138 |
|
|
What genetic component is associated with an increased risk of development of PM and Juvenile DM
|
HLA-DR3
|
|
|
What is the diagnostic criteria for PM/DM? x6
|
Symmetric weakness
Proximal muscle weakness EMG myopathic changes Characteristic abnormalities in biopsy Serum muscle enzymes elevated Typical rash for DM |
|
|
In PM/DM, what is the definite test for diagnosis?
|
Muscle Biopsy
|
|
|
What are the three rules to follow when doing a biopsy?
|
1. Must be obtained from weak/inflamed muscle
2. Avoid muscles with atrophy 3. Prefer to use Open Needle Biopsy |
|
|
What are the common pathological features of PM/DM? x4
|
1. Muscle fiber Degeneration
2. Muscle fiber Regeneration 3. Muscle fiber Necrosis 4. Inflammatory cell infiltrate (lymphocytic) |
|
|
Which IIM is a humorally mediated disorder?
|
DM
|
|
|
Which IIM is a cell mediated disorder?
|
PM
|
|
|
Pathological features specific for DM. x4
|
Perivascular Inflammation
Perifascicular atrophy/necrosis B lymphocytes Increased ratio of CD4/CD8 T-cells |
|
|
Pathological features specific for PM. x3
|
Infiltrate within fascicle
CD8+ T cells NO VASCULOPATHY |
|
|
PM/DM:
- Symptoms x3 |
1. Symmetric and Proximal weakness
2. Reflux 3. Aspiration 4. Dysphagia 5. Dysphonia |
|
|
PM/DM:
- What muscles are spared? - Pain |
Facial and ocular muscles
20-25% |
|
|
PM/DM:
- Non-muscle related symptoms x4 |
Fever
Raynaud's Arthritis Weight loss |
|
|
Skin manifestations of DM x2
|
Gottron's papules
Heliotrope rash |
|
|
What is pathognomonic for DM?
|
Gottron's papules
|
|
|
What labs would you expect in PM/DM? x4
|
Increased CK
Increased Aldolase Positive ANA Positive anti-JO-1 |
|
|
Prognosis for PM/DM?
|
80% to 90% have 15 yr survival rate
|
|
|
In what population group is morbidity/mortality worse?
|
Black females
|
|
|
What type of patients should be screened for underlying malignancy in association with IIM?
|
Over 50 y.o. with new onset IIM.
|
