Musculoskeletal: Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA)

Description

SGUL LOBs for Musculoskeletal: Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA).
Andrew Street
Flashcards by Andrew Street, updated more than 1 year ago
Andrew Street
Created by Andrew Street about 8 years ago
7
0

Resource summary

Question Answer
PMR & GCA are types of l..... v...... v...... large vessel vasculitis
1805 Clinical features of PMR. * Sudden onset of +++P & stiffness in shoulders, neck, hips, lumbar spine ('limb girdle pattern'). Sx +++ in AM - may last several hours. * Pt is usually >50 YO * 1/3 of pt's have systemic Sx - tiredness, fever, weight loss, depression. K & C p542.
1805 Clinical features of GCA. * Generally occurs in >50 YO & alongside PMR * Severe HA * Tenderness of scalp or temple * Claudication of the jaw when eating * Tenderness & swelling in one or more temporal or occipital arteries * Sudden, painless, loss of vision in one eye. K & C p543.
1807 Ix of PMR. * ^ ESR and/or CRP is a hallmark of this condition. It is rare to see PMR without an acute-phase response. * Serum alkaline phosphatase and γ-glutamyl-transpeptidase may be raised as markers of the acute inflammation. * Anaemia (mild normochromic, normocytic) is often present. * Temporal artery biopsy shows giant cell arteritis in 10–30% of cases, but is rarely performed unless GCA is also suspected. K & C p543.
1807 Ix of GCA. * Normochromic, normocytic anaemia * ^ ESR (in the region of 50–120 mm/h) and the CRP very high * Liver biochemistry. Abnormalities occur, as in PMR. The albumin may be low * A temporal artery biopsy from the affected side is the definitive diagnostic test. This should be taken before, or within 7 days of starting, high doses of corticosteroids. The lesions are patchy and the whole length of the biopsy (>1 cm long) must be examined; even so, negative biopsies occur. K & C p543.
* Outline the management of PMR/GCA and the potential long term complications of Rx. * Corticosteroids - should produce a dramatic reduction of Sx. If not seek alternative Dx. Doses ^ in GCA than PMR. If GCA is suspected start Rx immediately to avoid loss of sight. Prednisalone is usually used - tapered over 18/12. Calcium & vit D, & sometimes bisphosphonates, are needed to prevent osteoporosis. K & C p543.
Show full summary Hide full summary

Similar

Joints
Hannah Tribe
Musculoskeletal Extended Matching Questions
Chris Mulryan
Musculoskeletal Anatomy Quiz
Trisha Hoque Hossain
Medical-Surgical Nursing Quiz: Musculoskeletal, Upper GI & Cancer Part 1
M W
Opthamology: Conditions Causing Acute Loss Of Vision (Stroke, GCA, Central Retinal Artery and Vein Occlusion, Vitreous Haemorrhage, Retinal Detachment)
Andrew Street
Musculoskeletal Development
Hannah Tribe
PMR and TA
esther.westwood
Introduction to Vertebral Column
Samantha Fredman
Principles of fractures and dislocations
Samantha Fredman
MUSCULOSKELETAL USMLE
Trisha Hoque Hossain