q2 - kola

[ArchivalUser]

A 44-year-old woman presents with diffuse myalgias and excessive fatigue. She has morning stiffness and pain of all her joints, especially her wrists, elbows, shoulders, hips, knees, and neck. She does not sleep well at night. Her symptoms have been progressing for over 4 years. On physical examination, the patient has 13 tender points at the elbows, knees, shoulders, and hips. Which of the following is the most likely diagnosis?
1. Polymyalgia rheumatica

2. Fibromyalgia syndrome

3. Rheumatoid arthritis

4. Scleroderma

5. Polymyositis

[ArchivalUser]

2

[ArchivalUser]

3?

[ArchivalUser]

1...

[ArchivalUser]

22-The history and physical examination revealing tender points makes fibromyalgia syndrome the most likely diagnosis. This is a disorder predominantly of females; patients complain of insomnia, easy fatigability, and widespread musculoskeletal pain and stiffness. There are up to 18 symmetrical bilateral tender points that occur in the same locations on all patients. Laboratory data are normal in primary fibromyalgia syndrome.