Musculoskeletal by AI Flashcards
What is Scleroderma also known as?
Systemic Sclerosis
Scleroderma is characterized by inflammation and autoimmunity, vascular injury, and tissue fibrosis.
What triggers Raynaud’s phenomenon?
Cold and stress
This condition causes pain and is often assessed by SpO2 in different locations.
What are the major symptoms of Scleroderma?
- Taut skin
- Calcium deposits
- Limited mobility/contractures
- Skeletal muscle myopathy
- Nerve compression
Scleroderma can also affect the cardiovascular system, pulmonary system, and kidneys.
What is CREST syndrome?
A limited form of Scleroderma
It includes Calcinosis, Raynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia.
What are common cardiovascular complications in Scleroderma?
- Systemic and pulmonary hypertension
- Dysrhythmias
- Congestive heart failure
Symptoms of pulmonary hypertension include JVD, finger clubbing, and pulmonary edema.
What is a significant risk associated with Scleroderma during anesthesia?
Aspiration risk
This is due to gastrointestinal issues such as reflux and poor dentition.
What condition is characterized by a mutation in the dystrophin gene?
Duchenne Muscular Dystrophy (DMD)
DMD leads to pseudohypertrophy and affects primarily boys aged 2-5 years.
What are the initial symptoms of Duchenne Muscular Dystrophy?
- Waddling gait
- Frequent falling
- Difficulty climbing stairs
These symptoms are related to muscle weakness.
What is the effect of Myasthenia Gravis on the neuromuscular junction?
Decreased functional post-synaptic ACh receptors
This leads to muscle weakness and rapid exhaustion of voluntary muscles.
List the classifications of Myasthenia Gravis.
- Type I: Extraocular muscle involvement
- Type IIa: Mild skeletal muscle weakness
- Type IIb: Rapidly progressive weakness
- Type III: Acute onset and rapid deterioration
- Type IV: Severe muscle weakness
Each type varies in severity and progression.
What are the key symptoms of Myasthenia Gravis?
- Ptosis
- Diplopia
- Dysphagia
- Respiratory failure
These symptoms can worsen during infections.
What is the difference between Myasthenic Crisis and Cholinergic Crisis?
- Myasthenic Crisis: Drug resistance or insufficient therapy
- Cholinergic Crisis: Excessive anticholinesterase treatment
Symptoms of cholinergic crisis include profound muscle weakness and muscarinic side effects.
What is the primary treatment for Myasthenia Gravis?
Anticholinesterases
Pyridostigmine is preferred over neostigmine.
What is Osteoarthritis?
A degenerative process affecting articular cartilage
It commonly affects weight-bearing joints like knees and hips.
What are common treatments for Osteoarthritis?
- Physical therapy
- Pain relief measures
- Joint replacement surgery
- Avoidance of corticosteroids
Non-invasive treatments are preferred before considering surgery.
What is the most common chronic inflammatory arthritis?
Rheumatoid Arthritis
It is more prevalent in women than men and affects multiple joints.
What are the characteristic symptoms of Rheumatoid Arthritis?
- Painful synovial inflammation
- Morning stiffness
- Symmetrical joint involvement
It rarely affects the thoracic or lumbar spine.
What are the treatment options for Rheumatoid Arthritis?
- NSAIDs
- Corticosteroids
- Disease-modifying antirheumatic drugs (DMARDs)
- Surgery for severe cases
Methotrexate is a common DMARD used.
What is Systemic Lupus Erythematosus characterized by?
Antinuclear antibody production
It is a multisystem chronic inflammatory disease affecting young women and African Americans.
What are typical manifestations of Systemic Lupus Erythematosus?
- Antinuclear antibodies
- Malar rash
- Thrombocytopenia
- Serositis
- Nephritis
These manifestations arise from immune-mediated tissue damage.
What is a common renal complication in Systemic Lupus Erythematosus?
Glomerulonephritis
This can lead to decreased glomerular filtration rate (GFR).
What is a common renal manifestation of Systemic Lupus Erythematosus?
Glomerulonephritis, decreased GFR
List three central nervous system symptoms of Systemic Lupus Erythematosus.
- Cognitive dysfunction
- Psychological changes
What cardiovascular symptoms are associated with Systemic Lupus Erythematosus?
- Pericarditis
- Coronary atherosclerosis
- Raynaud’s
What pulmonary complications are related to Systemic Lupus Erythematosus?
- Lupus pneumonia
- Restrictive lung disease
- Vanishing lung syndrome
What gastrointestinal symptoms can occur in Systemic Lupus Erythematosus?
- ABD pain
- Pancreatitis
- Elevated liver enzymes
What hematological issues are commonly seen in Systemic Lupus Erythematosus?
- Thromboembolism
- Thrombocytopenia
- Hemolytic anemia
What skin manifestations are characteristic of Systemic Lupus Erythematosus?
- Butterfly-shaped malar rash
- Discoid lesions
- Alopecia
What are some treatment options for Systemic Lupus Erythematosus?
- NSAIDs or ASA
- Anti-malarial
- Hydroxychloroquine
- Corticosteroids
- Immunosuppressants (Methotrexate, azathioprine)
What is a key consideration in anesthesia management for patients with Systemic Lupus Erythematosus?
Based upon manifestations and organ dysfunction
What airway complications may occur in Systemic Lupus Erythematosus?
- Recurrent laryngeal nerve palsy
- Cricoarytenoid arthritis
What is the recommended management for stress in patients with Systemic Lupus Erythematosus during anesthesia?
Stress dose of corticosteroids
What is Malignant Hyperthermia?
Hypermetabolic syndrome
List three symptoms of Malignant Hyperthermia.
- Increased HR
- Increased BP
- Increased CO2
What genetic mutation is associated with Malignant Hyperthermia?
Ryanodine receptor - RYR1 gene
What factors can trigger Malignant Hyperthermia?
- Exposure to inhaled VA
- Succinylcholine
What is the mortality rate associated with Malignant Hyperthermia?
50%
What is a key physiological change in Malignant Hyperthermia?
Uncontrolled elevation of sarcoplasmic calcium
What are some treatments for Malignant Hyperthermia?
- D/C all triggering gas/drugs
- Hyperventilate with 100% O2
- Change breathing circuit and soda lime
- Dantrolene (initial dose 2.5 mg/kg, max 10 mg/kg)
What should be done post-operatively for Malignant Hyperthermia patients?
- Transfer to ICU 24-48 hours
- Report to MH registry
What is the purpose of muscle biopsy contracture testing in Malignant Hyperthermia?
To test for susceptibility in the patient and family members
Fill in the blank: The initial dose of Dantrolene for Malignant Hyperthermia is _______.
2.5 mg/kg
