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25 Cards in this Set
- Front
- Back
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What is the basic problem behind Malignant Hyperthermia?
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Sarcoplasmic Reticulum loses its ability to bind or reuptake Calcium
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What triggers Malignant Hypertheremia?
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Volatile Anesthetics
Succinylcholine |
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What could you use in MH patient for anesthesia?
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Anything except Volatile and sux- you could use N20, IV induction agents, benzos, narcs, NDMBs, narcotics, locals.
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What are specific signs of MH?
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Increased CO2- early sign
Rhabdomyolysis Temp elevation Muscle Rigidity |
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What are nonspecific signs of MH?
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Tachycardia, tachypnea, acidosis, hyperkalemia
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What are some current concepts of MH for signs/symptoms, etc?
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Muscle rigidity may or may not be present. Temp elevation LATE sign. EtCO2 usually early sign, may occur at any point during anesthesia
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What receptor is associated with MH?
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Ryanodine receptor
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Who does masseter muscle rigidity affect more? Describe MMR, when it starts etc.
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Kids 4-12 Males more common. First clinical sign in 30% of patients.
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What are steps in treating MH?
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STOP OFFENDING AGENT
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What are similarities of MH to other Myopathies?
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Rhabdo, MMR, acidosis, positive or equivocal biopsy
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What is difference between Duchenne and Becker's Muscular dystrophy?
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Duchenne- death early age, absent dystrophin protein
Beckers- normal life span, defect on X chromosome, abnormal dystrophin protein |
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What is presenting sign/difference with MH to other myopathies?
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Hyperkalemia presenting sign in others
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What is the triad in the pathogenesis of MH?
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Ryanodine receptor
Terminal cisternae T-tubule |
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What are standard tests for MH?
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Halothane, or caffeine muscle biopsy test
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What is the only definitive test in detecting susceptibility for MH?
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Contracture muscle test- fresh vastus lateralis muscle needed, limited centers to test.
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What is the sensitivity/specificity of MH test?
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100/80
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When is MH testing contraindicated?
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Children <4 or <20kg
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What are significant predictors of MH crisis?
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Muscle rigidity
CK>20000 K>6 PaCO2>60 EtCO2 >55 Rapid rise in temp |
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What is treatment of acute phase of MH?
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discontinue offending agents
hyperventilate with 100% O2 NaHCO3 for hyperkalemia Dantrolene Cool pt. Treat antiarrythmias, no CCBs |
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What is dosage of Dantrolene in acute phase?
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2.5mg/kg up to 10mg
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What is dantrolene dose post-crisis phase?
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1mk/kg every 4-6 hours for 24 hours up to 36 hours
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What are some things you could do to prepare OR for MH susceptible patient?
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Shut down/disable vaporizers
Flow 10LPM O2 for 20min through machine/vent Change CO2 absorbant |
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What can you do to prevent cardiac arrests in MH and muscular disorder pts?
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Avoid MH trigger dumbass. Avoid Sux in childred and adolescents except in rare situations, monitor temp, have dantrolene available
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What is the genetic inheritence for MH?
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Autosomal dominant- affects more children, males
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What is most sensitive and specific clinical sign for MH?
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increase in EtCO2
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