MH

Question 1

What is MH?

Answer 1

Malignant Hyperthermia

Question 2

Pharmacological Syndome

Triggers

Answer 2

Volitile agent
Succinylchonline

Question 3

Genetic aspect

Answer 3

Type 1 ryanodine receptor
L-type Ca2+ channel (t-tubules)

Question 4

Ethnic predispostion

Answer 4

Scandanavian descent

North Midwest

Question 5

Physiology of calc release

Answer 5

1. AP opens calc channels→ACh
2. ACh→nicotinic R→Na+ in K+ out
3. Propagation of AP down t-tubules
4. L-type calc channels activate RyR1
5. SR releases calc

Question 6

Physiollogy of muscle contractions

Answer 6

1. Influx of calc binds to tropomyosin
2. Exposing myosin binding site, this binds to myosin head
3. ATP initiaits power stroke (skeletal movement )
4. SERCA pumps Calc back into SR

Question 7

Krebs cycle by-product

Answer 7

4 CO2

Lactic acidosis

Question 8

4 mechanism that cause MH

Answer 8

1. Transient hyponatremia
2. Transcient hypokalemia
3. ATP Hydrolysis (Heat production)
4. SERCA activtion (Heat production)

Question 9

What goes wrong in MH?

Answer 9

1. Dysregulation of excitation and contraciton coupling (stays on)
2. Sustainted RyR activation
3. Susatined Calc release → increased need for ATP
4. Impaired Mg2+ inhibtion of SR calc release

Question 10

4 things produced in excess during MH

Answer 10

• Rigor
• Heat
• CO2
• Lactate

Question 11

Awake trigger for MH?

Answer 11

• High intensity excercise
• Heat
• Anoxia (complete lack of O2 to organ)
• Apprehension

Question 12

Clinical signs