ACCP SEEK 23 SET 6

Question 1

BOTULISM

Answer 1

HISTORY OF CANNED VEGETABLES
PERIPHERAL WEAKNESS IN DESCENDING PATTERN
CONFIRMATION: TOXIN IN SERUM, SI SECRETIONS, STOOL
TREAT: BOTULSIM ANTITOXIN, SUPPORTIVE CARE
EMG IN BOTULISM: INCREMENTAL ACTION POTENTIAL

Question 2

TICK PARALYSIS

Answer 2

FLACCID PARALYSIS, NO CRANIAL NERVE INVOLVEMENT

TREATMENT: REMOVE THE TICK

Question 3

GUILLAIN BARRE SYNDROME

Answer 3

FOLLOWS ACUTE INFECTION
IN 95%:ASCENDING PARALYSIS
5%: MILLER FISHER VARIANT WITH OPHTHALMOPLEGIA, ATAXIA, AND NO DTRS. HAVE NORMAL PUPILLARY RESPONSE

Question 4

EATON LAMBERT SYNDROME

Answer 4

PROXIMAL LIMB WEAKNESS IN PTS WITH ACTIVE CANCER
EMG: DECREMENT IN MUSCLE POTENTIAL WITH SLOW NERVE STIMULATION BUT
FACILITATION >200% AFTER HIGH FREQUENCY STIMULATION

Question 5

MYASTHENIA GRAVIS

Answer 5

EMG: PROGRESSIVELY SMALLER, WEAKER POTENTIALS WITH STIMULATION
EDROPHONIUM TEST (TENSILON) CONFIRM
HAVE EXERCISE INDUCED WEAKNESS

Question 6

ANTIBIOTICS THAT CAN AFFECT MYASTHENIA

Answer 6

QUINOLONES AND AMINOGLYCOSIDES