Rare complication Flashcards

1
Q

What is malignant hyperpyrexia

A

Life threatening condition resulting from a genetic sensitivity of skeletal muscles to volatile anaesthetics and depolaring muscle neuromuscular blocking drugs

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2
Q

What is the genetics for malignant hyperpyrexia

A

Autosomal dominant

With variable penetrance

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3
Q

Presentation of malignant hyperpyrexia

A
Muscular rigidity 
Hypermetabolic state
Inc O2 consumption
Inc CO2 production 
hyperthermia 
Rhabdomyolysis
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4
Q

Pathophysiology

A

Mutation in the ryanodine 1 receptor on sarcoplasmic reticulum - stored calcium
Normal muscle - small amount of Ca2+ released when triggered then reabsorbed into the SR for the next cycle
In MH the receptor doesn’t close properly after opening for a stimulus so the there is excess ca2+ release as they are being sequestered but just leak out leading muscle rigidity symptoms
This uses lots of ATP - hypermetabolic
Produced excess heat - hyperaemic
Muscle cells get damaged by depletion of ATP so that the contents leak —> rhabdomyolysis
K+ leak —> hyperkalaemia

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5
Q

Triggers for malignant hyperpyrexia

A

Halothane

Suxamethonium

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6
Q

Tx malignant hyperpyrexia

A
Help
Hyperventilate the patient 100% O2
Finish or abort the procedure 
Cool patient
Clean the breathing system 
Cause diuresis
Treat hyperkalamia, dysrhythmias
Monitor CK
Monitor coagulation
Administer DANTROLENE
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7
Q

Test for malignant hyperpyrexia

A

Muscle biopsy at a special centre

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8
Q

What is pseudo cholinesterase deficiency

A

Inherited enzyme abnormality
There is abnormally slow tabloid degradation of exogenous choilne ester drugs
So you get a pronged duration of sux or LA ester - procaine and Cocaine

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