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  #1  
Old 01-05-2012
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Question Demonstration of 11 Tender Points!

A 50-year-old white female presents with aching and stiffness in the trunk, hip, and shoulders. There is widespread muscle pain after mild exertion. Symptoms are worse in the morning and improve during the day. They are also worsened by stress. The patient is always tired and exhausted. She has trouble sleeping at night. On exam, joints are normal but there are multiple points of tenderness over the occiput, neck, lateral epicondyle, and medial fat pad of the knee. ESR is normal, and there is no history of Lyme disease or HIV disease exposure. A definitive diagnosis is best made by ?

A. Trial of glucocorticoids
B. Muscle biopsy
C. Demonstration of 11 tender points
D. Psychiatric evaluation
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b...muscle biopsy as i was thnkg 2 diagnosis polymyalgia rheumatica n ra..
as ra no test is given as in serum Ab testing or xray ill go with b..
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no i guess now that I read again I'll go with pychiatric evaluation as patient shows signs of depression and could be somatization...

how could I mis that!!!damn
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answer is C... fibromyalgia ....
pt will have min 8 tender points as described in the question....
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I would go with C
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Old 01-06-2012
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Quote:
Originally Posted by vishalmethre View Post
answer is C... fibromyalgia ....
pt will hav min 8 tender points as described in d question....
where have u read about fibromyalgia? which book?
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Old 01-06-2012
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Answer C

8 out of 11 tender points is definitive diagnosis of fibromyalgia
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Old 01-06-2012
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Typical case of fibromyalgia I will go with C
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Old 01-06-2012
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Quote:
Originally Posted by step_enhancer View Post
Answer C

8 out of 11 tender points is definitive diagnosis of fibromyalgia
I believe the criteria to qualify is 11/18 tender sites... altho i see a lot of u using 8/11 pts for the dx

also, the sx's have to be present for > 3 months... there is no mention of the period of sx's present...

the presentation sounds a 100% like Fibromyalgia....scopus??
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Old 01-06-2012
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Correct Answer fibromyalgia

i came across the answer while reviewing the USMLE world, but to be honest it isn't listed in FA 2011 Musculoskeletal section at all....

Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.

The cause is unknown. Possible causes or triggers of fibromyalgia include:

Physical or emotional trauma

Abnormal pain response - areas in the brain that are responsible for pain may react differently in fibromyalgia patients

Sleep disturbances

Infection, such as a virus, although none has been identified

Fibromyalgia is most common among women aged 20 to 50.

To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including

Arms (elbows),Buttocks,Chest,Knees,Lower back,Neck,Rib cage,Shoulders,Thighs
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Old 01-06-2012
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sign and symptoms:

The defining symptoms of fibromyalgia are chronic, widespread pain, fatigue, and heightened pain in response to tactile pressure (allodynia). Other symptoms may include tingling of the skin, prolonged muscle spasms, weakness in the limbs, nerve pain, muscle twitching, palpitations, functional bowel disturbances,and chronic sleep disturbances.

Cause
1 Genetic predisposition
2 Stress
3 Dopamine dysfunction (hypodopaminergia)
4 Abnormal serotonin metabolism
5 Deficient growth hormone (GH) secretion
6 Psychological factors
7 Physical trauma
8 Poor sleep
9 Adenosine monophosphate deaminase deficiency type 1
10 Neuro-immunoendocrine disorder
11 Other hypotheses

Demonstration of 11 Tender Points!-fibromyalgia.jpg
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Old 01-06-2012
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Quote:
Originally Posted by ab_baby View Post
I believe the criteria to qualify is 11/18 tender sites... altho i see a lot of u using 8/11 pts for the dx

also, the sx's have to be present for > 3 months... there is no mention of the period of sx's present...

the presentation sounds a 100% like Fibromyalgia....scopus??
haha thx actually i wrote it somewhere in my first aid and i couldnt find it today sorry for wrong info
i guess everybody tells take notes in first aid and now my first aid is a encyclopedia notes all over the book but cannot find stuff when needed
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Old 01-06-2012
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FIBROMYALGIA the same question with almost same symptoms was given in the UW saying morning stiffness exacerbated by exercise/stress
multiple symmetricaly distributed tenders spots over muscles,joints such as spine of scapula
lateral epicondlye
medial fat pads of knees etc.,
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C. Fibromyalgia
UW concept
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Old 01-07-2012
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Quote:
Originally Posted by doxorubicin View Post
wer hav u read abt fibromyalgia? which book?
as hypermedic said its a question frm Uworld....
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Old 01-07-2012
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C. Demonstration of 11 tender points

fibromylagia
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  #17  
Old 01-07-2012
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it is fibromyalgia - demonstration of 11 tender points
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Old 01-08-2012
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Now which antidepressant can be used as a treatment option for fibromyalgia?....

check it in FA 2011..u will see it..cheers
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Old 01-09-2012
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Quote:
Originally Posted by stfidel View Post
Now which antidepressant can be used as a treatment option for fibromyalgia?....

check it in FA 2011..u will see it..cheers
lol... u drove me crazy!! hehe cudnt find it in FA.. pls give the answer....

cud diagnose fibromyalgia from the uworld question!
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