neuromuscular junction

Question 1

NMJ disorder for Ach inhibitors

Answer 1

synaptic

Question 2

NMJ disorder for snake venom

Answer 2

post synaptic

Question 3

Anti-Ach receptor antibodies attacking the postsynaptic muscle membrane decreasing number of receptors and blocking remaining receptors

Answer 3

myasthenia Gravis

Question 4

Anti-Ca Channel antibodies attack the presynaptic neuron membrane and prevent Ach release

Answer 4

Lambert Eaton syndrome

Question 5

acts at presynaptic neuron membrane and prevent release of Ach

Answer 5

Botulism

Question 6

Dx: Fatigability and fluctuation

Answer 6

Myasthenia Gravis

Question 7

what are the main causes of Myasthenia Gravis

Answer 7

Anti-Acetylcholine receptor antibodies

Question 8

When is it appropriate to initiate mechanical ventilation?

Answer 8

Negative inspiratory force (NIF) less negative than -30 cmH2O

Forced vital capacity <15-20 ml/Kg

significant hypoxemia

patient distress

Inability to protect airway (maintain patency, swallow secretion, etc

Question 9

what is the classic tumor association with Myasthenia Gravis

Answer 9

thymus cancer

Question 10

what is the prominant symptom for MG

Answer 10

ocular, upper extremities

Question 11

what is the prominent symptoms for Lambert-eaton

Answer 11

Hip girdle

Question 12

how are the reflexes for MG? Lambert?

Answer 12

normal on stretch for MG; reflexes diminished on lambert; hypoactive or absent

Question 13

response to muscle stimulation for MG? Lambert eaton?

Answer 13

symptoms worsen for MG; symptoms improve for Lambert eaton

Question 14

Tx for botulism

Answer 14

Antibiotic therapy is INEFFECTIVE

symptoms may present up to 3 months

Question 15

Cancer screening for Lambert eaton syndrome

Answer 15

image them until they glow! patient has cancer until proven otherwise
chest xray—>CT chest–>PET scan tip to tail

Question 16

what is the classic tumor association for Lambert eaton?

Answer 16

lung cancer (small cell lung CA)