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IMSK Exam 3 > TBL 2 > Flashcards

TBL 2 Flashcards

1
Q

Why do patients experiencing malignant hyperthermia have their body temperatures rise?

A

Hypermetabolism

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2
Q

What muscle relaxant can cause MH?

A

Succinylcholine

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3
Q

How is MH inherited?

A

Autosomal dominant with reduced or incomplete penetrance

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4
Q

What is MH a disorder in?

A

Genetic mutation in RyR1 (ryanodine receptor) in skeletal muscles or CACNA1S gene coding for L-type Ca2+ channel; dihydropyridine receptor

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5
Q

What does MH cause in patients?

A 
CO2 production
Oxygen consumption
Metabolic and respiratory acidosis
Hyperkalemia
Heat production
Sympathetic nervous system activation
Problems coagulating
Multi-organ dysfunction and failure
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6
Q

What test is standard for diagnosing MH?

A

Caffeine halothane contracture test

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7
Q

How much can oxygen consumption increase?

A

3 fold

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8
Q

How much can blood lactate levels increase?

A

15-20 fold

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9
Q

Why is the sympathetic nervous system stimulated in MH?

A

Release of catecholamines

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10
Q

What drug is given to treat MH?

A

Dantrolene

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11
Q

How does Dantrolene work?

A

Specifically inhibits the release of calcium from the SR in skeletal muscle and reverses the process

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12
Q

When does activation of the sympathetic nervous system begin in the disease process?

A

Early

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13
Q

Why does disseminated intravascular coagulation occur?

A

Due to release of tissue thromboplastin

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14
Q

Which chromosome is the RyR1 gene located on?

A

Chromosome 19

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15
Q

How many sites in the US test muscle biopsies for MH?

How many test for MH gene mutations?

A

5

2

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16
Q

What are known triggering agents of MH?

A

Depolarizing neuromuscular blockers such as succinylcholine and halogenated volatile anesthetics (end in -ane)

17
Q

What are three agents suspected of causing MH but no longer used as general anesthetics?

A

Diethyl ether
Chloroform
Cyclopropane

18
Q

What in general are considered safe for patient with MH?

A

Local anesthetics and non-depolarizing NM blockers

19
Q

What is the earliest sign of MH?

A

Increase in end-tidal carbon dioxide

20
Q

What are three disorders in patients that place them at high risk for MH?

A

King-Denborough syndrome
Central core disease
Minicore myopathy

21
Q

What characterizes King-Denborough syndrome?

A

Short stature
Musculoskeletal abnormalities
Mental retardation
Sometimes central core disease

22
Q

What characterizes central core disease? (Same symptoms of minicore myopathy)

A

Hypotonia

Muscle weakness

23
Q

What can occur if you administer succinylcholine to a muscular dystrophy patient?

A

Hyperkalemia

Rhabdomyolysis

24
Q

What is a more effective way of testing for MH?

A

Muscle biopsy

Positive genetic test does not mean they have it and a negative does not rule them out

IMSK Exam 3 (16 decks)

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