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Optimizing fibromyalgia management

doi: 10.1097/01.NPR.0000413539.40681.fb
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INSTRUCTIONS Optimizing fibromyalgia management


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Optimizing fibromyalgia management

General Purpose: To increase the NP's ability to effectively recognize and manage patients with FM. Learning Objectives: After reading this article and taking this test, the NP should be able to: 1. Describe the demographics and clinical aspects of FM. 2. Discuss currently accepted treatment protocols for FM.

  1. At what age is a patient most likely to present with FM?
    1. 33 years
    2. 45 years
    3. 57 years
    4. 61 years
  2. FM treatment may be delayed because
    1. the symptoms are mistaken for other diseases.
    2. there are no definitive diagnostic criteria available.
    3. FM is misconstrued as psychosomatic.
    4. practitioners are not familiar with the disease.
  3. A genetic correlation with a first-degree relative increases the risk of developing FM
    1. 6 fold.
    2. 8 fold.
    3. 10 fold.
    4. 12 fold.
  4. The biological basis for most symptoms of FM is associated with sensory processing that is
    1. enhanced.
    2. diminished.
    3. slowed.
    4. faulty.
  5. Altered pain sensitivity in FM is related to glutamate, which is a/an
    1. passive neurotransmitter.
    2. active neurotransmitter.
    3. excitatory neurotransmitter.
    4. nociceptive neurotransmitter.
  6. Biomarkers for FM in cerebrospinal fluid are not useful in clinical practice because they
    1. are difficult to measure.
    2. can be misleading.
    3. relate to many conditions other than FM.
    4. do not alter treatment decisions.
  7. The chief complaint of FM patients is body pain originating from the
    1. ligaments and tendons.
    2. skin.
    3. muscles and joints.
    4. abdomen.
  8. The phenomenon of “Fibro Fog” consists of all of the following symptoms except
    1. forgetfulness.
    2. concentration difficulties.
    3. decreased mental alertness.
    4. long-term memory loss.
  9. All of the following comorbidities are common with FM except
    1. temporomandibular disorders.
    2. urine retention.
    3. mood disorders.
    4. irritable bowel syndrome.
  10. Which of the following pharmacologic agents is FDA-approved for FM?
    1. hydrocortisone
    2. tramadol
    3. milnacipran
    4. cyclobenzaprine
  11. Which of the following drugs for chronic pain is not specifically approved for FM?
    1. duloxetine
    2. tramadol
    3. milnacipran
    4. pregabalin
  12. In addition to depression and anxiety, antidepressants are used in FM to treat
    1. insomnia.
    2. restless legs syndrome.
    3. memory loss.
    4. pain.
  13. Nonpharmacologic management of FM is mainly comprised of exercise and
    1. diet.
    2. restorative sleep.
    3. cognitive behavioral strategies.
    4. meditation.
  14. Critical components of structured exercise include aerobic, strength, flexibility, and
    1. balance training.
    2. body movement away from the midline.
    3. pivotal movements.
    4. isometrics.
  15. Patients with FM can be advised to avoid holding the arms overhead to decrease
    1. fatigue.
    2. muscle microtrauma.
    3. hyperextension.
    4. loss of balance.
  16. To maximize use of the large muscles of the hips and thighs, the patient should gradually increase
    1. knee bends.
    2. straight leg lifts.
    3. heel raises.
    4. standing time.
  17. Which of the following statements is correct?
    1. Acupuncture is not a useful treatment option for FM.
    2. Patients with FM may be deficient in nutrients needed for neurologic function.
    3. Research studies found that Tai Chi does not improve symptom management in FM.
    4. Approximately 75% of women with FM take herbal supplements.
  18. Which food additive has been linked to FM symptoms?
    1. guar gum
    2. food coloring
    3. monosodium glutamate
    4. linoleic acid


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