MRCGP International OSCE: Statin-Induced Myopathy

Vocabulary flashcards covering the differential diagnoses, history-taking components, red flags, and physical examination signs for statin-induced myopathy from an MRCGP OSCE case scenario.

Statin-associated muscle symptoms (SAMS)

The most likely diagnosis for muscle pain and weakness in a patient on statin therapy, given the temporal relationship to starting or increasing the dose.

Statin-induced myopathy with CK elevation

A more significant form of statin-induced muscle disorder that requires creatine kinase (CK) confirmation.

Rhabdomyolysis

A rare but serious condition requiring immediate recognition, characterized by very high CK, myoglobinuria, and renal impairment.

Polymyalgia rheumatica

A differential diagnosis presenting with proximal pain and stiffness that exhibits a different pattern (worse in the morning) and is accompanied by a raised ESR.

Nocebo effect

A well-documented phenomenon in which symptoms are attributed to a statin without an underlying pharmacological cause.

Interacting drugs increasing statin levels

Medications such as amlodipine, clarithromycin, and ciclosporin that raise statin levels and increase the risk of myopathy.

Red flag signs of statin myopathy

Severe muscle weakness or pain (especially if rapidly progressive) and dark ('cola-coloured') urine suggesting myoglobinuria.

Muscle symptom characteristics (SAMS)

Symptoms that are typically symmetrical and proximal (affecting thighs and shoulders) and characterized by ache, cramp, or weakness.

Functional impact assessment

Evaluation of severity based on functional difficulties, such as climbing stairs, rising from chairs, and performing overhead activities.

Gait assessment

Part of the general examination utilized as a functional mobility screen in suspected statin-induced myopathy.

Muscle examination

A focused system examination that specifically assesses tenderness, symmetry, and objective weakness using formal power testing.