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10 Cards in this Set
- Front
- Back
What is myasthenia Gravis?
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Autoimmune disease characterized by weakness and easy fatiqability of skeletal muscle and is cassified according to whether the patient has only ocular or ocular and nonocular muscle weakness.
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What is the pathophysicology of myasthenia gravis?
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Weakness is thought to be due to an autoimmune disease or inactivation of postsynaptic acetylcholine receptors at the nmj leading to a reduced number of receptors.
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what drugs are commonly used to treat muscle weakness in MG?
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Anticholinesterase drugs-- they increase the amount of acetylcholine at the neuromuscular junction through inhibition of end-plate acetylcholinesterase.
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What is a cholinergic crisis?
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characterized by increased weakness and excessive muscarinic effects, including salivation, diarrhea, miosis and bradycardia. (caused by excessive anticholinergic)
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What is the surgery of choice for MG?
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Thymectomy
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What is the focus of preoperative evaluation before a thymectomy?
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Recent course of the disease
Muscle groups affected Drug therapy coexisting illnesses |
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what is the biggest risk with MG patients preop?
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Aspiration-- pts should not receive benzodiazepines prior, and should receive Metoclopramide or an H2 Blocker to decrease this risk.
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What is the response to succinylcholine by MG patients?
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Unpredictable-- pts may have a resistance, a prolonged effect or and unusaul block--phase II block.
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What is the response to NDMR's by MG patients?
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Increased sensitivity to NDMR, even a small defasciculating dose in some may result in complete paralysis.
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What are the predictive respiratory values for respiratory failure in MG patients?
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disease > 6yrs
PIP of < -25cmH2O VC <4 mL/kg pyridostigmine dose > 750mg/d |