Objectives:

• Describe the appropriate evaluation of polyarthralgia and sicca symptoms
• Define diagnostic criteria for fibromyalgia and Sjögren’s syndrome
• Implement appropriate therapy for fibromyalgia and Sjögren’s syndrome

1		Once again, your fabled diagnostic and therapeutic abilities have earned you a well-deserved referral. Your patient is very happy with the way things are going with her Sjögren’s syndrome. She refers her sister-in-law to you. The sister-in-law is 46 years old and reports having been diagnosed with fibromyalgia several months ago. She takes only acetaminophen and codeine as needed for pain. Which of the following is the BEST option for treating fibromyalgia?
			A)	Tramadol (Ultram).
			B)	Hydromorphone (OxyContin).
			C)	Acetaminophen with codeine.
			D)	Nortriptyline (Pamelor).
			E)	Fluoxetine (Prozac) or another SSRI.
2		All of the following are associated with fibromyalgia EXCEPT:
			A)	Irritable bowel syndrome and other GI findings.
			B)	Fullness/swelling of hands and feet.
			C)	Paresthesias.
			D)	Fatigue.
			E)	Night sweats.