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FM Learner
105 Topics*
Allergy*
Dehydration*
Epistaxis*
Fatigue*
Immigrants*
Loss of Consciousness*
Loss of Weight*
Pain*
Palliative*
Periodic Screening*
Red Eye*
Renal Failure*
Sexual Assault*
Shortness of Breath*
Smoking Cessation*
Travel Medicine*
Trauma*
♥
ACLS*
Acute Coronary Syndrome
Anemia*
Iron-Deficiency Anemia
B12 Deficiency Anemia
Atrial Fibrillation*
Chest Pain*
DVT*
EKG
Heart Failure*
Hyperlipidemia*
Hypertension*
INR
Ischemic Heart Disease*
Pulmonary Embolism
Derm*
Acne
Fungal Disease
Genital Ulcers
Lacerations*
Leg edema
Psoriasis
Rosacea
Urticaria/Angioedema
GI
Abdominal Pain*
Abnormal Liver Tests
Anorectal pathology
Biliary disease
Celiac
Diarrhea*
Dyspepsia*
GI Bleed*
Hepatitis*
Inflammatory Bowel Disease
Irritable Bowel Syndrome
NAFLD/NASH
Endo
Osteoporosis*
Diabetes*
Diabetic Ulcer
DKA/HHS
Hyperkalemia
Hyponatremia
Obesity*
Thyroid*
Thyroid Nodule
ID*
Antibiotic Classes
Cellulitis
Dysuria* / UTI*
Earache* / AOM
Fever*
Immunization*
Meningitis*
Pharyngitis
Pneumonia*
Rhinosinusitis
STIs*
URTI*
MSK
Fibromyalgia
Fractures*
Gout
Joint Disorder*
Knee Pain
Neck Pain*
Low-back Pain*
Nocturnal Leg Symptoms
Polymyalgia Rheumatica
Rheumatoid Arthritis
Shoulder Pain
Neuro
Bell's Palsy
Concussion / mTBI
Dementia*
Dizziness*
Tremor
Seizures*
Stroke*
Parkinsonism*
Headache*
OBGYN
Vaginitis*
Vaginal Bleeding*
Urinary Incontinence
Pregnancy Termination
Pregnancy*
Postpartum Complications
Polycystic Ovarian Syndrome
Nipple Discharge
Menopause*
Infertility*
Hypertensive Disorders of Pregnancy
Contraception*
Breast Lump*
Peds
NRP
Pediatric Fractures
Petechiae/Purpura
Pediatric UTI
Pediatric Urology
Pediatric Shock
Pediatric Fever
PALS
Newborn*
Neonatal Jaundice
In Children*
Well-baby Care*
Food protein-induced proctocolitis
Failure to Thrive
Infantile Colic
Hip Pain
Febrile Seizure
Enuresis
Encopresis
Croup*
Ψ
ADHD
Anxiety*
Bipolar
Depression* / Suicide*
Eating Disorders*
Insomnia*
Personality Disorder*
Poisoning*
Schizophrenia*
Somatization*
Substance Use*
Alcohol Use and Withdrawal
Opioid Use
Resp
Hemoptysis
Cough*
COPD*
Asthma*
Uro
Interstitial Cystitis
Hematuria
Nephrolithiasis
Prostate*
Sex*
Other
Bedside Ultrasound
Central Line
Chest Tube
Intraosseous Line
Intubation
Lumbar Puncture
Medical Marijuana
Medical Education
Medical Assistance in Dying
Procedural Sedation
SAMPs
SOOs
Urine dipstick
FM Learner
105 Topics*
Allergy*
Dehydration*
Epistaxis*
Fatigue*
Immigrants*
Loss of Consciousness*
Loss of Weight*
Pain*
Palliative*
Periodic Screening*
Red Eye*
Renal Failure*
Sexual Assault*
Shortness of Breath*
Smoking Cessation*
Travel Medicine*
Trauma*
♥
ACLS*
Acute Coronary Syndrome
Anemia*
Iron-Deficiency Anemia
B12 Deficiency Anemia
Atrial Fibrillation*
Chest Pain*
DVT*
EKG
Heart Failure*
Hyperlipidemia*
Hypertension*
INR
Ischemic Heart Disease*
Pulmonary Embolism
Derm*
Acne
Fungal Disease
Genital Ulcers
Lacerations*
Leg edema
Psoriasis
Rosacea
Urticaria/Angioedema
GI
Abdominal Pain*
Abnormal Liver Tests
Anorectal pathology
Biliary disease
Celiac
Diarrhea*
Dyspepsia*
GI Bleed*
Hepatitis*
Inflammatory Bowel Disease
Irritable Bowel Syndrome
NAFLD/NASH
Endo
Osteoporosis*
Diabetes*
Diabetic Ulcer
DKA/HHS
Hyperkalemia
Hyponatremia
Obesity*
Thyroid*
Thyroid Nodule
ID*
Antibiotic Classes
Cellulitis
Dysuria* / UTI*
Earache* / AOM
Fever*
Immunization*
Meningitis*
Pharyngitis
Pneumonia*
Rhinosinusitis
STIs*
URTI*
MSK
Fibromyalgia
Fractures*
Gout
Joint Disorder*
Knee Pain
Neck Pain*
Low-back Pain*
Nocturnal Leg Symptoms
Polymyalgia Rheumatica
Rheumatoid Arthritis
Shoulder Pain
Neuro
Bell's Palsy
Concussion / mTBI
Dementia*
Dizziness*
Tremor
Seizures*
Stroke*
Parkinsonism*
Headache*
OBGYN
Vaginitis*
Vaginal Bleeding*
Urinary Incontinence
Pregnancy Termination
Pregnancy*
Postpartum Complications
Polycystic Ovarian Syndrome
Nipple Discharge
Menopause*
Infertility*
Hypertensive Disorders of Pregnancy
Contraception*
Breast Lump*
Peds
NRP
Pediatric Fractures
Petechiae/Purpura
Pediatric UTI
Pediatric Urology
Pediatric Shock
Pediatric Fever
PALS
Newborn*
Neonatal Jaundice
In Children*
Well-baby Care*
Food protein-induced proctocolitis
Failure to Thrive
Infantile Colic
Hip Pain
Febrile Seizure
Enuresis
Encopresis
Croup*
Ψ
ADHD
Anxiety*
Bipolar
Depression* / Suicide*
Eating Disorders*
Insomnia*
Personality Disorder*
Poisoning*
Schizophrenia*
Somatization*
Substance Use*
Alcohol Use and Withdrawal
Opioid Use
Resp
Hemoptysis
Cough*
COPD*
Asthma*
Uro
Interstitial Cystitis
Hematuria
Nephrolithiasis
Prostate*
Sex*
Other
Bedside Ultrasound
Central Line
Chest Tube
Intraosseous Line
Intubation
Lumbar Puncture
Medical Marijuana
Medical Education
Medical Assistance in Dying
Procedural Sedation
SAMPs
SOOs
Urine dipstick
More
105 Topics*
Allergy*
Dehydration*
Epistaxis*
Fatigue*
Immigrants*
Loss of Consciousness*
Loss of Weight*
Pain*
Palliative*
Periodic Screening*
Red Eye*
Renal Failure*
Sexual Assault*
Shortness of Breath*
Smoking Cessation*
Travel Medicine*
Trauma*
♥
ACLS*
Acute Coronary Syndrome
Anemia*
Iron-Deficiency Anemia
B12 Deficiency Anemia
Atrial Fibrillation*
Chest Pain*
DVT*
EKG
Heart Failure*
Hyperlipidemia*
Hypertension*
INR
Ischemic Heart Disease*
Pulmonary Embolism
Derm*
Acne
Fungal Disease
Genital Ulcers
Lacerations*
Leg edema
Psoriasis
Rosacea
Urticaria/Angioedema
GI
Abdominal Pain*
Abnormal Liver Tests
Anorectal pathology
Biliary disease
Celiac
Diarrhea*
Dyspepsia*
GI Bleed*
Hepatitis*
Inflammatory Bowel Disease
Irritable Bowel Syndrome
NAFLD/NASH
Endo
Osteoporosis*
Diabetes*
Diabetic Ulcer
DKA/HHS
Hyperkalemia
Hyponatremia
Obesity*
Thyroid*
Thyroid Nodule
ID*
Antibiotic Classes
Cellulitis
Dysuria* / UTI*
Earache* / AOM
Fever*
Immunization*
Meningitis*
Pharyngitis
Pneumonia*
Rhinosinusitis
STIs*
URTI*
MSK
Fibromyalgia
Fractures*
Gout
Joint Disorder*
Knee Pain
Neck Pain*
Low-back Pain*
Nocturnal Leg Symptoms
Polymyalgia Rheumatica
Rheumatoid Arthritis
Shoulder Pain
Neuro
Bell's Palsy
Concussion / mTBI
Dementia*
Dizziness*
Tremor
Seizures*
Stroke*
Parkinsonism*
Headache*
OBGYN
Vaginitis*
Vaginal Bleeding*
Urinary Incontinence
Pregnancy Termination
Pregnancy*
Postpartum Complications
Polycystic Ovarian Syndrome
Nipple Discharge
Menopause*
Infertility*
Hypertensive Disorders of Pregnancy
Contraception*
Breast Lump*
Peds
NRP
Pediatric Fractures
Petechiae/Purpura
Pediatric UTI
Pediatric Urology
Pediatric Shock
Pediatric Fever
PALS
Newborn*
Neonatal Jaundice
In Children*
Well-baby Care*
Food protein-induced proctocolitis
Failure to Thrive
Infantile Colic
Hip Pain
Febrile Seizure
Enuresis
Encopresis
Croup*
Ψ
ADHD
Anxiety*
Bipolar
Depression* / Suicide*
Eating Disorders*
Insomnia*
Personality Disorder*
Poisoning*
Schizophrenia*
Somatization*
Substance Use*
Alcohol Use and Withdrawal
Opioid Use
Resp
Hemoptysis
Cough*
COPD*
Asthma*
Uro
Interstitial Cystitis
Hematuria
Nephrolithiasis
Prostate*
Sex*
Other
Bedside Ultrasound
Central Line
Chest Tube
Intraosseous Line
Intubation
Lumbar Puncture
Medical Marijuana
Medical Education
Medical Assistance in Dying
Procedural Sedation
SAMPs
SOOs
Urine dipstick
Fibromyalgia
General Overview
If accompanied by
widespread
pain
(typically in muscles and joints), consider
Fibromyalgia
, requires all of:
Widespread pain index
(WPI) ≥ 7 and symptom severity (SS) scale score ≥ 5 or WPI 3-6 and SS scale score ≥ 9
Shoulder, hip, jaw, chest, abdomen, upper/lower arm/leg/back
Fatigue, waking unrefreshed, cognitive symptoms
Symptoms present at similar level for ≥ 3 months
Absence of disorder that would otherwise explain pain
Treatment
Psychotherapy
Graduated exercise program (aerobic, resistance-training)
Tai-Chi
Low evidence for raw vegetarian diet
Consider pharmacologic treatment
Amitryptyline 25-50mg PO qHS (most evidence)
Pregabalin 150-450mg/day in divided doses
Cyclobenzaprine 5-20mg PO qHS (sleep)
Duloxetine 60mg PO daily (pain)
Paroxetine, Fluoxetine
References:
Canadian Guidelines for the Diagnosis and Management of Fibromyalgia Syndrome in Adults.
http://fmguidelines.ca/
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