Malignant hyperthermia-ANSWER is a life-threatening familial hypermetabolic
disorder of skeletal muscle that may be precipitated by specific anaesthetic
agents.
characteristics of MH-ANSWER tachycardia, tachypnea, hyperthermia,
generalized muscle rigidity, acidosis, and increasing ETCO2 levels.
how fast does the temperature increase with MH?-ANSWER Rapid increase in
temperature by as much as 1o C every 5 mins.
How does acidosis result from MH? -ANSWER-is a result of increased skeletal
muscle metabolism that may proceed to rhabdomyolysis.
pathophysiology of malignant hyperthermia - ANSWER Calcium is released
from the SR at very high rates, leading to a sustained hypermetabolic state and
subsequent loss of cellular integrity. Later in the clinical course, ATP
production ceases, causing failure of intracellular membrane pumps. Cellular
leakage of electrolytes follows including potassium and calcium, enzymes such
as creatine phosphokinase, large amounts of metabolic acids and myoglobin.
Fatal arrhythmias, end-organ damage and eventually death may ensue.
what is the consequence of MH hypermetabolic state? - ANSWER rising
lactate levels, high adenosine triphosphate {ATP} utilization, increasing carbon
dioxide production, increasing oxygen utilization and muscle heat accumulation
secondarily to sustained muscle contracture.
, which of the following receptor has been implicated in the pathogenesis of MH?
- ANSWER Type 1 Ryanodine receptor
What is the "Gold Standard" for diagnosing MH? - ANSWER in vitro
halothane-caffeine contracture test (IVCT)
how is the IVCT test done? - ANSWER The muscle is exposed to halothane
and caffeine-containing solutions, and the force of contraction is measured as
the endpoint. Muscle from a patient with MH susceptibility shows an increased
force of contraction.
who should be tested with IVCT? - ANSWER This test should be used for
susceptible patients (e.g., with personal or family history of MH).
Physical changes with MH-ANSWER muscles contractures and increased core
body temperature
What lab values will you see with MH?-ANSWER increased serum creatine
kinase levels, myoglobinuria, Hypoxemia
Hypercapnia and Hyperkalemia.
What type of acidosis will you see with MH?-ANSWER Metabolic acidosis and
Respiratory acidosis mixed
Earliest signs of MH during anesthesia - ANSWER Masseter muscle spasm,
Increased heat rate and increased production of carbon dioxide - a result of
increased muscle metabolism, Oxygen consumption increases three to five fold
CO2 increases - doubling or tripling in a relatively brief time.
disorder of skeletal muscle that may be precipitated by specific anaesthetic
agents.
characteristics of MH-ANSWER tachycardia, tachypnea, hyperthermia,
generalized muscle rigidity, acidosis, and increasing ETCO2 levels.
how fast does the temperature increase with MH?-ANSWER Rapid increase in
temperature by as much as 1o C every 5 mins.
How does acidosis result from MH? -ANSWER-is a result of increased skeletal
muscle metabolism that may proceed to rhabdomyolysis.
pathophysiology of malignant hyperthermia - ANSWER Calcium is released
from the SR at very high rates, leading to a sustained hypermetabolic state and
subsequent loss of cellular integrity. Later in the clinical course, ATP
production ceases, causing failure of intracellular membrane pumps. Cellular
leakage of electrolytes follows including potassium and calcium, enzymes such
as creatine phosphokinase, large amounts of metabolic acids and myoglobin.
Fatal arrhythmias, end-organ damage and eventually death may ensue.
what is the consequence of MH hypermetabolic state? - ANSWER rising
lactate levels, high adenosine triphosphate {ATP} utilization, increasing carbon
dioxide production, increasing oxygen utilization and muscle heat accumulation
secondarily to sustained muscle contracture.
, which of the following receptor has been implicated in the pathogenesis of MH?
- ANSWER Type 1 Ryanodine receptor
What is the "Gold Standard" for diagnosing MH? - ANSWER in vitro
halothane-caffeine contracture test (IVCT)
how is the IVCT test done? - ANSWER The muscle is exposed to halothane
and caffeine-containing solutions, and the force of contraction is measured as
the endpoint. Muscle from a patient with MH susceptibility shows an increased
force of contraction.
who should be tested with IVCT? - ANSWER This test should be used for
susceptible patients (e.g., with personal or family history of MH).
Physical changes with MH-ANSWER muscles contractures and increased core
body temperature
What lab values will you see with MH?-ANSWER increased serum creatine
kinase levels, myoglobinuria, Hypoxemia
Hypercapnia and Hyperkalemia.
What type of acidosis will you see with MH?-ANSWER Metabolic acidosis and
Respiratory acidosis mixed
Earliest signs of MH during anesthesia - ANSWER Masseter muscle spasm,
Increased heat rate and increased production of carbon dioxide - a result of
increased muscle metabolism, Oxygen consumption increases three to five fold
CO2 increases - doubling or tripling in a relatively brief time.
