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  #1  
Old 11-07-2011
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Default Rheumatology

A 35 year old women complaining of aching all over. She says she sleeps poorly and her muscles and joints hurt. Her symptoms have progressed over several years. She says she is desperate because pain and weakness often cause her to drop things. Physical examination shows multiple points of tenderness over the shoulders, neck, elbows and wrists. There is no joint swelling or deformity. A complete blood count and ESR are normal. Rheumaroid factor is negative. Which of the following is the best theraputic option in this patient ?

a) Gaded aeorbic exercise.
b) prednisone.
c) weekley MTX.
d) Hydroxychloroquine.
e) NSAID.
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  #2  
Old 11-07-2011
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Default prednisone

Quote:
Originally Posted by sam88 View Post
A 35 year old women complaining of aching all over. She says she sleeps poorly and her muscles and joints hurt. Her symptoms have progressed over several years. She says she is desperate because pain and weakness often cause her to drop things. Physical examination shows multiple points of tenderness over the shoulders, neck, elbows and wrists. There is no joint swelling or deformity. A complete blood count and ESR are normal. Rheumaroid factor is negative. Which of the following is the best theraputic option in this patient ?

a) Gaded aeorbic exercise.
b) prednisone.
c) weekley MTX.
d) Hydroxychloroquine.
e) NSAID.
prednisone
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  #3  
Old 11-08-2011
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a.graded exercise
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  #4  
Old 11-08-2011
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My diagnosis would be polymyalgia rheumatica... DOC is prednisolone
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  #5  
Old 11-08-2011
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Fibromyalgia - the younger age and multiple points of tenderness give it away... but a poor question if asking for therapy because there are no accepted cures for fibromyalgia except for symptom management - which is best done with TCAs or anticonvulsants. (not in answer choices) Special exercises are an accepted therapy for fibromyalgia.. so id chose that...
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Old 11-08-2011
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i go with fibromyalgia
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  #7  
Old 11-08-2011
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bt donno abt the treatment
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  #8  
Old 11-08-2011
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Okay the diagnosis is fibromyalagia for sure as for the treatment i was as confused as you are guys here's the explanation :
The correct answer is A. The pateients multiple tender points associated sleep disturbance and lack of joint findings make fibromyalagia a likely diagnosis.
Cognitive behavioral therapy and graded aeorbic exercises have been demonstrated to relieve symptoms. TCAay help restore sleep NSAIDS and other anti inflammatory drugs are not helpful.

So any suggestions on how reliable this is ? The source is pretest medicine
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  #9  
Old 11-08-2011
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Quote:
Originally Posted by sam88 View Post
Okay the diagnosis is fibromyalagia for sure as for the treatment i was as confused as you are guys here's the explanation :
The correct answer is A. The pateients multiple tender points associated sleep disturbance and lack of joint findings make fibromyalagia a likely diagnosis.
Cognitive behavioral therapy and graded aeorbic exercises have been demonstrated to relieve symptoms. TCAay help restore sleep NSAIDS and other anti inflammatory drugs are not helpful.

So any suggestions on how reliable this is ? The source is pretest medicine
pretest has a penchant for trying to create the hardest questions and torturing students. i hated the ones i did for step 1 .. and scored horribly.. although i did well on step1 (253). ... i can say for sure that given a choice between exercise and neuropathic analgesics .. one should choose the latter... that should be in the answer choices in a good question.
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