1. fibromyalgia: chronic widespread musculoskeletal pain/tenderness
increased prevalence of other syndromes such as CFS, IBS, TMD, chronic
headaches.
CNS is most likely involved in maintaining pain and other core symptoms.
significant negative consequences for quality of life
poorly understood...
DPT 6 Exam 4 (Shatnawi 1.0)
Study online at https://quizlet.com/_g690gb
1. fibromyalgia: chronic widespread musculoskeletal pain/tenderness
increased prevalence of other syndromes such as CFS, IBS, TMD, chronic
headaches.
CNS is most likely involved in maintaining pain and other core symptoms.
significant negative consequences for quality of life
poorly understood and difficult-to-diagnose condition
2. epidemiology of fibromyalgia: 2-3% prevalence rate
9:1 women to men
age onset: between 30 and 35 years
similar across socioeconomic classes
cultural factors play a role in seeking medical attention
3. true or false: the patho of fibromyalgia is not yet well known: true
4. the pathophysiology of fibromyalgia is related to...: *a pain-processing prob-
lem in the brain*
patients become hypersensitive to pain
the constant pain can also be associated with psychological problems
5. in fibromyalgia, there is dysfunctions in mono-aminergic neurotransmis-
sion such as...: *increased* excitatory neurotransmitters:
-glutamate and substance P
*decreased* levels of serotonin and norepinephrine in the spinal cord at the level of
descending anti-nociceptive pathways.
6. there is an increased level of circulating inflammatory cytokines in fi-
bromyalgia such as...: IL-6, IL-8, IL-1²and TNF-±
7. pathophysiology of fibromyalgia in terms of normal patients and those with
FM: altered sensory afferent pain processing and impaired descending noxious
inhibitory control leading to hyperalgesia have been demonstrated in FM
, DPT 6 Exam 4 (Shatnawi 1.0)
Study online at https://quizlet.com/_g690gb
MRI clearly demonstrates activation of brain regions involved in the experience of
pain in FM patients in response to stimuli that do not elicit pain in normal subjects
pain perception in FM patients is influenced significantly more by emotional and
cognitive domains compared to normal subjects
8. are there defects in the __________(inhibitory) systems and hyperactivity in
the ___________ pain pathway: descending, ascending
9. what is FM considered?: a central sensitivity syndrome
10. central sensitization: a neuronal signal amplification mechanism within the
central nervous system that leads to a greater perception of pain
11. what neurotransmitters have a suppressive effect on the pain-descneing
pathway?: 5-HT and NE
they stimulate the release of enkephalins from short interneurons
12. enkephalins: endogenous ligands that activate opioid receptors
inhibit the release of the vesicles from 1st order neuron
inhibit depolarization of the 2nd order neuron
13. true or false: there is a number of genes are likely involved in pain and
stress pathways contribute to the vulnerability of developing FM: true
14. what gene alterations are associated with pain sensitivity in FM?: COMT
alterations of NE and DA
beta-adrenergic receptor and DA receptor
15. what genes are associated with metabolism, transport, and receptors for
serotinin implicated in FM?: SLC64A4, 5-HTT, 5-HT2AR and COMT
16. true or false: there are certain polymorphisms or haplotypes associated
with FM, CFS: true
17. clinical manifestations of FM in terms of *pain*: all over
poorly localized
difficult to ignore
severe in intensity
must be present most of the day for 3 months
, DPT 6 Exam 4 (Shatnawi 1.0)
Study online at https://quizlet.com/_g690gb
18. clinical manifestations of FM in terms of the *tender point exam*: ACR: 18
well-defined sites using pressure
non-muscular mechanical pressure, heat, cold, etc.
rule out specific musculoskeletal diseases
19. what may be triggers for widespred pain due to CNS factors (WPI)?: periph-
eral pain generators
20. is musculoskeletal pain a common compliant of fibromyalgia?: yes
worse when exercising, cold weather, or under stress
21. is the differential diagnosis of FM broad or specific?: broad
22. what should patients with inflammatory causes for widespread pain be
identified based on?: specific history
physical findings
laboratory or radiographic tests
23. what are the typical neuropsychological symptoms of FM?: *varying de-
grees but not in all patients or at all times*
fatigue
stiffness
cognitive dysfunction
anxiety and depression
24. fatigue in FM: highly prevalent
25. stiffness in FM: often worsened by exercise or unaccustomed activity
26. sleep disturbance in FM: may meet criteria for restless leg syndrome and
sleep-disorder breathing; always feeling un-refreshed
27. cognitive dysfunction in FM: slow processing
difficulty with attention/ concentration and word retrieval
short term-memory loss
28. anxiety and depression in FM: common; life-time prevalence about 80%
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