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Self-Assessment Questions

Rheumatology

Myopathy: Review Questions

Janet Filemyr Krommes, MD

Dr. Krommes is in private practice with Rheumatology Associates, Mercerville, NJ.


Choose the single best answer for each question.

1. An 18-year-old football player is referred for evaluation of severe muscle cramping that occurred during games and elevated creatine kinase (CK) levels. On further questioning, he reports that he had similar muscle cramps as a wrestler in middle school when he restricted caloric intake and used a garbage bag under his clothes to manage his weight. What syndrome is suggested by this patient’s acute episodes of pain with prolonged exertion?
  1. Benign muscle fasciculation
  2. Duchenne’s muscular dystrophy
  3. Inclusion body myositis
  4. Inflammatory myopathy
  5. Storage diseases
Click here to compare your answer.


2. A 47-year-old woman is hospitalized for profound muscle weakness. Respiratory status is stable. Past medical history is significant for well-controlled hyperlipidemia and diabetes. She is generally healthy and has no symptoms consistent with a connective tissue disease. The patient’s initial CK level exceeds 55,000 U/L, and all other laboratory tests are normal. What medication is the most likely cause of this patient’s myopathy?

  1. Cholestyramine
  2. Gemfibrozil
  3. Lovastatin
  4. Lovastatin and cholestyramine
  5. Lovastatin and gemfibrozil
Click here to compare your answer.


  3. The rash of dermatomyositis is best characterized as which of the following?
  1. Fine, diffuse, sandpaper-like rash
  2. Urticarial lesions in a sun-exposed distribution
  3. Hyperpigmented, hyperkeratotic with follicular plugging
  4. Pink, popular lesions found on the extensor surfaces
  5. Petechial rash predominantly on the lower extremities
Click here to compare your answer.


4. A 56-year-old woman with asthma is hospitalized for a severe exacerbation. After the bronchospasm improves, the patient has difficulty getting out of bed. Physical examination reveals proximal weakness, and pulmonary function testing shows a new restrictive pattern. The patient’sCK level is 5445 U/L. What information will be helpful in making the appropriate treatment decisions?

  1. Stage III breast cancer diagnosed 3 years ago
  2. Severe fatigue and weight loss of 20 lb
  3. Recent infection with coxsackievirus B
  4. Progressive dyesthesia in a stocking and glove distribution
  5. Presence of anti-Jo-1 antibodies
Click here to compare your answer.



 

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