Rheumatology: fibromyalgia: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Rheumatology: fibromyalgia

Sample item

A 38-year-old woman has widespread musculoskeletal pain, fatigue and unrefreshing sleep for a year, with multiple tender points and normal ESR, CRP and CK. What is the best initial management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Education, graded aerobic exercise and sleep hygiene

Fibromyalgia is a central pain-sensitisation syndrome diagnosed clinically with normal inflammatory markers. Education, graded aerobic exercise and cognitive behavioural therapy are first-line, with duloxetine, pregabalin or low-dose amitriptyline as drug options. Steroids, opioids and NSAIDs are ineffective or harmful.

Option by option

  • A. Long-term high-dose NSAIDs

    NSAIDs are of little benefit in this non-inflammatory condition.

  • B. Regular strong opioids

    Opioids are not recommended and risk dependence.

  • C. Long-term prednisolone

    Steroids have no role since there is no inflammation.

  • D. Education, graded aerobic exercise and sleep hygiene (correct)

    Correct. Non-drug measures are the foundation of treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Education, graded aerobic exercise and sleep hygiene. Fibromyalgia is a central pain-sensitisation syndrome diagnosed clinically with normal inflammatory markers.

Why is "Long-term high-dose NSAIDs" not the answer?

NSAIDs are of little benefit in this non-inflammatory condition.

Why is "Regular strong opioids" not the answer?

Opioids are not recommended and risk dependence.

Why is "Long-term prednisolone" not the answer?

Steroids have no role since there is no inflammation.

What concept does this question test?

It tests Rheumatology: fibromyalgia in General Medicine. Education, graded aerobic exercise and cognitive behavioural therapy are first-line, with duloxetine, pregabalin or low-dose amitriptyline as drug options. Steroids, opioids and NSAIDs are ineffective or harmful.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Rheumatology: fibromyalgia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.