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  #1  
Old 01-22-2013
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Default Musculosk Q

A 35-year-old woman presents to her primary
care physician with complaints of progressive
weakness over the past month. She says she has
noticed an increasing amount of diffi culty associated
with getting out of chairs, climbing
stairs, brushing her hair, and lifting her 3-yearold
son out of his playpen, an activity that she
was able to do without diffi culty prior to the
onset of her weakness. She admits to missing 3
days of work approximately 6 weeks ago due to
“a bad cold.” Physical examination is remarkable
for symmetric proximal muscle weakness.
Several tests are ordered to establish a diagnosis.
Which of the following most strongly supports
a diagnosis of polymyositis?
(A) β-Amyloid deposits noted on muscle biopsy
(B) Increased creatine kinase levels
(C) Normal creatine kinase levels
(D) Perifascicular atrophy noted on muscle
biopsy
(E) Positive rheumatoid factor
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  #2  
Old 01-22-2013
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Quote:
Originally Posted by aknz View Post
A 35-year-old woman presents to her primary
care physician with complaints of progressive
weakness over the past month. She says she has
noticed an increasing amount of diffi culty associated
with getting out of chairs, climbing
stairs, brushing her hair, and lifting her 3-yearold
son out of his playpen, an activity that she
was able to do without diffi culty prior to the
onset of her weakness. She admits to missing 3
days of work approximately 6 weeks ago due to
“a bad cold.” Physical examination is remarkable
for symmetric proximal muscle weakness.
Several tests are ordered to establish a diagnosis.
Which of the following most strongly supports
a diagnosis of polymyositis?
(A) β-Amyloid deposits noted on muscle biopsy
(B) Increased creatine kinase levels
(C) Normal creatine kinase levels
(D) Perifascicular atrophy noted on muscle
biopsy
(E) Positive rheumatoid factor
My answer is D) Perifascicular atrophy noted on muscle
biopsy
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  #3  
Old 01-22-2013
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I will go with B
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Old 01-22-2013
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(B) Increased creatine kinase levels
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Old 01-22-2013
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(B) Increased creatine kinase levels


-->Perifascicular atrophy noted on muscle biopsy= associated with Dermatomyositis
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  #6  
Old 01-23-2013
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.
B. increased ck level because its only elevated in polymyosistis
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Old 01-23-2013
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Elevated creatine kinase (B)
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Old 01-23-2013
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Yeah, I think it's (B) increased CK too.
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Old 01-23-2013
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Polymyositis, dermatomyositis,
and inclusion body myositis are all
idiopathic infl ammatory arthropathies. Although
the etiology behind these disorders is
largely unknown, they typically present with
progressive bilateral muscle weakness. Diagnostic
distinction between the three entities is
made on muscle biopsy
. In addition, CK levels
may provide further distinction between the
disorders. Polymyositis is always associated with
increased CK levels
. CK levels in dermatomyositis
and inclusion body myositis can be normal,
and therefore cannot be used to rule out
these two diseases.

Perifascicular atrophy
is a classic biopsy fi nding in dermatomyositis.
It
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