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Cert Prep > Valley: Neuromusclar Diseases > Flashcards

Valley: Neuromusclar Diseases Flashcards

1
Q

Are muscular dystrophy neuromuscular diseases hereditary?

A

Yes

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2
Q

Painless degeneration and atrophy of skeletal muscles (associated with mental retardation)

A

Muscular dystrophy

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3
Q

What are the 4 classifications of muscular dystrophy?

A
  1. Pseudohypertrophic muscular dystrophy
  2. Limb-girdle muscular dystrophy
  3. Facioscapulohumeral muscular dystrophy (heart not involved)
  4. Nemaline rod muscular dystrophy
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4
Q

Which classification has the characteristics of: CHF, recurrent pneumonia, kyphoscoliosis, hyperkalemia with sux, susceptible to MH

A

Pseudohypertrophic muscular dystrophy

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5
Q

Which classification has the characteristics of: micrognathia, bulbar palsy

A

Nemaline rod muscular dystrophy

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6
Q

Which muscular dystrophy is the most common and most severe?

A

Duchenne’s muscular dystrophy

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7
Q

Is duchenne’s muscular dystrophy x or y / dominant or recessive DNA?

A

X-linked recessive

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8
Q

Duchenne’s muscular dystrophy affects the lung volume in what 2 ways?

A
  1. Reduce total lung capacity
  2. Reduce residual volume
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9
Q

What type of heart block is common with Duchenne’s muscular dystrophy?

A

Bundle branch block

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10
Q

Duchenne’s muscular dystrophy has an increased incidence of ——, so avoid —.

A

Malignant hyperthermia , succinylcholine

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11
Q

Characterized by random and multiple sites of demyelination of corticospinal tract neurons in the brain and spinal cord, exclusive of the peripheral neurons.

A

Multiple sclerosis

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12
Q

S/s of which neuromuscular disease: visual disturbances, ataxia, limb paresthesia and weakness, spastic paresis of skeletal muscles, exacerbations and remission

A

Multiple sclerosis

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13
Q

What are the 5 common treatments (palliative) for multiple sclerosis?

A
  1. Corticosteroids
  2. Avoid stress
  3. Avoid marked temperature changes
  4. Dantrolene
  5. Carbamazepine
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14
Q

Multiple sclerosis management of anesthesia: — in response to succinylcholine

A

Hyperkalemia

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15
Q

Multiple sclerosis management of anesthesia: prevent — body temperature postoperatively

A

Increased

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16
Q

A chronic autoimmune disease involving the neuromuscular junction. It is characterized by weakness and rapid exhaustion of skeletal muscles with repetitive use; in some recovery with rest

A

Myasthenia Gravis

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17
Q

What are the 5 most common signs and symptoms with myasthenia gravis:

A
  1. Ptosis and diplopia
  2. Weakness of pharyngeal and laryngeal muscles (aspiration risk!)
  3. Asymmetric extremity skeletal muscle weakness (atrophy absent!)
  4. Cardiomyopathy
  5. Hypothyroidism
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18
Q

What are the 5 most common treatments for myasthenia gravis:

A
  1. Anticholinesterase drugs
  2. Corticosteroids
  3. Cyclosporine
  4. Plasmapheresis
  5. Thymectomy (elective operation)
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19
Q

Myasthenia Gravis preoperative preparation: — opioids and inform pt of possible —— postoperative

A

Avoid , mechanism ventilation

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20
Q

Myasthenia gravis induction: —— IV drugs , tracheal intubation — muscle relaxants

A

Short acting , without

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21
Q

Can you use muscle relaxants for maintenance with Myasthenia Gravis pts?

A

Yes, short or intermediate acting muscle relaxants

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22
Q

Myasthenia Gravis postoperative: skeletal muscle strength may — abruptly

A

Decrease

23
Q

Degenerative disease of the CNS characterized by loss of dopaminergic fibers in the basal ganglia of the brain

A

Parkinson’s Disease

24
Q

— is an inhibitory neurotransmitter acting on the extrapyramidal motor system in Parkinson’s Disease

A

Dopamine

25
Q

What are the 4 most common signs and symptoms with Parkinson’s Disease?

A
  1. Skeletal muscle rigidity
  2. Resting tremor
  3. Diaphragmatic spasms
  4. Mental depression
26
Q

What are the 3 most common treatments for Parkinson’s Disease?

A

Increase concentration of dopamine
1. Levodopa (combo with decarboxylase inhibitor)
2. Anticholinergic drugs
3. Antihistamine drugs

27
Q

— levodopa therapy during management of anesthesia for Parkinson’s Disease

A

Continue

28
Q

Parkinson’s Disease will have a — BP and cardiac — during management of anesthesia.

A

Labile , dysrhythmias

29
Q

What 3 drugs do you avoid in Parkinson’s Disease with management of anesthesia?

A

Avoid drugs with antidopaminergic effects
1. Droperidol !!
2. Possibly opioids
3. Reglan

30
Q

Chronic inflammatory disease characterized by symmetric polyarthropathy and significant systemic involvement.

A

Rheumatoid Arthritis

31
Q

Rheumatoid arthritis has — vertebral involvement but no — involvement.

A

Cervical , sacroiliac

32
Q

Rheumatoid arthritis is most common in — that are — - — years old.

A

Females , 30-50

33
Q

A condition marked by hyperemia of the conjunctiva, lacrimal deficiency, thickening of the corneal epithelium, itching and bruising of the eye, and often reduced visual acuity

A

Keratoconjunctivitis Sicca

34
Q

What are the 4 most common treatments for rheumatoid arthritis?

A
  1. Aspirin
  2. Corticosteroids
  3. Gold
  4. Surgery
35
Q

Airway evaluation for rheumatoid arthritis includes — disease

A

Restrictive

36
Q

Rheumatoid arthritis includes hoarseness or stridor, due to —— involvement.

A

Cricoarytenoid joint

37
Q

Rheumatoid arthritis may need — intubation and postoperative —.

A

Fiberoptic , ventilation

38
Q

Degenerative process that affects the articular cartilage and differs from rheumatoid arthritis due to lack of (or minimal) inflammatory reaction.

A

Osteoarthritis

39
Q

Osteoarthritis will have degenerative changes are primarily in the middle to lower — spine and in the lower — area.

A

Cervical , lumbar

40
Q

Would you treat osteoarthritis with corticosteroids?

A

NO

41
Q

Lateral curvature of spine

A

Scoliosis

42
Q

— scoliosis is most common type.

A

Idiopathic

43
Q

— pattern of breathing with thoracic scoliosis.

A

Restrictive

44
Q

What 6 lung measurements will decrease with scoliosis?

A
  1. Vital capacity
  2. Total lung capacity
  3. Inspiratory volume
  4. Functional residual capacity
  5. Inspiratory capacity
  6. ERV
45
Q

What is the only lung measurement that may be normal with scoliosis?

A

Residual volume

46
Q

FEV1/FVC is — in scoliosis.

A

Normal

47
Q

Scoliosis may develop elevated ——— and —— leading to right heart failure.

A

Pulmonary vascular resistance , pulmonary hypertension

48
Q

This cardiac valve issue is the most common abnormality with scoliosis.

A

Mitral valve prolapse

49
Q

Pts with neuromuscular scoliosis may lose — ml/kg.

A

75

50
Q

Deliberate — with the blood pressure in scoliosis pts because you — want to compromise spinal cord blood flow and to what MAP is desired?

A

Hypotension , do not , MAP 60-65 mmHg

51
Q

Parameters for extubation with pts having scoliosis:
Vital capacity, tidal volume, spontaneous respiration rate, and negative inspiratory force.

A

Vital capacity: >10ml/kg
Tidal volume: >3ml/kg
Spontaneous respiration rate: <30/min
Negative inspiratory force: >-30cmH2O

52
Q

What are the 5 most common complications with scoliosis?

A
  1. Pneumothorax
  2. Atelectasis
  3. Pleural effusion
  4. Hemothorax
  5. Neurologic injury
53
Q

With scoliosis pts, avoid — and favor — drugs.

A

Succinylcholine , nitrous oxide

Cert Prep (20 decks)

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