Fibromyalgia Lecture Powerpoint

Question 1

Fibromyalgia definition

Answer 1

Common cause in women age 20-55 of chronic widespread musculoskeletal pain, accompanied by fatigue, cognitive disturbance, and multiple somatic symptoms, etiology is unknown, pathophysiology is uncertain, despite symptoms of pain affecting muscles, ligaments, and tendons there is no evidence of tissue inflammation

Question 2

Clinical manifestations of fibromyalgia (6)

Answer 2

• Diffuse bilateral top to bottom widespread musculoskeletal pain** involving both sides of body and areas above and below waist
• poor sleep patterns
• fatigue exacerbated by minor activities
• association with other disorders such as IBS, neuropathy, migraines, chronic bladder irritation
• tenderness at multiple soft tissue anatomic locations
• cognitive and mood disturbances

Question 3

Central sensitization

Answer 3

Idea that fibromyalgia is a disorder of pain regulation that causes the brain to feel far more pain

Question 4

Sleep EEG in fibromyalgia

Answer 4

See delta sleep with alpha intrusion similar to what is seen in normal nonREM sleep but with consistent stage 4 sleep deprivation

Question 5

Lab evals to rule out fibromyalgia (4)

Answer 5

• CBC
• ESR
• thyroid function test
• biochemical screen

Question 6

2010 AC criteria for diagnosis of fibromyalgia

Answer 6

• rely only upon symptoms, disregard tender point evaluation

- symptoms at least 3 months where no other disorder would explain, wide spread pain presence and fatigue

Question 7

Differential diagnosis of fibromyalgia (6)

Answer 7

• SLE
• sjogrens
• RA
• hypothyroidism
• polymyalgia reumatica
• myofascial pain syndrome

Question 8

Poor prognostic indicators of fibromyalgia (3)

Answer 8

• symptoms for long period
• severe symptoms with limitation of activities
• work disability

Question 9

Management of fibromyalgia (8)

Answer 9

• rule out other disease
• education and support
• exercise (stretching and aerobic activity)
• improve sleep hygiene
• avoid caffeine and tobacco
• Nsaids
• antidepressants
• muscle relaxant