Malignant Hyperthermia Overview
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Questions and Answers

What is the underlying cause of the increased carbon dioxide levels in malignant hyperthermia?

  • Increased carbon dioxide production by the liver.
  • Decreased lung capacity due to muscle spasms.
  • Increased respiratory rate due to pain.
  • Increased metabolic activity due to muscle contraction. (correct)

    • What is the primary mechanism by which dantrolene treats malignant hyperthermia?

  • Inhibiting the breakdown of acetylcholine.
  • Blocking the release of calcium from the sarcoplasmic reticulum. (correct)
  • Reducing the release of acetylcholine at the neuromuscular junction.
  • Increasing the uptake of calcium by the sarcoplasmic reticulum.

    • Which of the following is NOT a characteristic sign of malignant hyperthermia?

  • Increased carbon dioxide production.
  • Decreased heart rate. (correct)
  • Rapid increase in body temperature.
  • Muscle rigidity.

    • Which of the following conditions contributes to metabolic acidosis in malignant hyperthermia?

    <p>Increased production of lactic acid due to oxygen deprivation. (B)</p> Signup and view all the answers

    Why might beta blockers be ineffective in controlling tachycardia in malignant hyperthermia?

    <p>The tachycardia in this condition is primarily caused by hypermetabolism and acidosis, not by sympathetic nervous system stimulation. (B)</p> Signup and view all the answers

    What is the role of dantrolene in the treatment of malignant hyperthermia?

    <p>To prevent the binding of calcium to troponin, allowing muscle relaxation. (D)</p> Signup and view all the answers

    What is the most immediate concern in a patient experiencing malignant hyperthermia?

    <p>Hyperthermia. (C)</p> Signup and view all the answers

    Which of the following measures is NOT directly used in the treatment of malignant hyperthermia?

    <p>Administering a blood transfusion. (A)</p> Signup and view all the answers

    Flashcards

    Malignant Hyperthermia

    A life-threatening reaction to certain anesthesia causing muscle contractions, heat, CO₂, and tachycardia.

    Normal Muscle Contraction

    Involves an electrical impulse causing acetylcholine release, leading to calcium release and muscle contraction.

    Rhabdomyolysis

    Breakdown of skeletal muscle releasing myoglobin into blood, causing kidney obstruction and potassium release.

    Dantrolene

    A muscle relaxant that antagonizes RyR1 receptors, blocking calcium flow to prevent muscle contraction.

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    Tachycardia

    Increased heart rate due to O₂ demand from muscles in hypermetabolism and acidosis.

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    Hypercarbia

    Excess CO₂ in the body due to muscle contraction, leading to increased CO₂ levels.

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    Hyperkalaemia

    Elevated potassium levels resulting from muscle damage during contractions, affecting heart function.

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    Hyperthermia

    Increased body temperature due to tachycardia and muscle overactivity, potentially rising rapidly.

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    Study Notes

    Malignant Hyperthermia

    • Triggered by excessive skeletal muscle contraction, producing heat and elevated CO2, alongside tachycardia.
    • Life-threatening reaction to certain anesthetic agents (e.g., succinylcholine).

    Normal Muscle Contraction

    • Action potential triggers acetylcholine release, leading to muscle depolarization.
    • Depolarization releases calcium from the sarcoplasmic reticulum.
    • Calcium binds to troponin, causing actin-myosin interaction and muscle contraction.
    • ATP is used during contraction, producing heat.

    Malignant Hyperthermia (MH)

    • Genetic abnormality resulting in excessive calcium release from RyR1 receptors within muscle cells.
    • Excessive calcium leads to sustained muscle contractions, generating significant heat and CO2.
    • Prolonged muscle contraction depletes ATP stores, worsening the metabolic acidosis.
    • Elevated CO2 further contributes to respiratory acidosis.

    Changes Associated with MH

    • Increased body temperature, typically rising 1°C every few minutes.
    • Tachycardia (rapid heart rate) due to increased metabolic demands.
    • Hypercarbia (high CO2 levels) due to excessive muscle metabolism.
    • Muscle rigidity.
    • Metabolic acidosis due to lactic acid buildup.
    • Hypokalemia (low potassium levels) due to release into extracellular fluid.
    • Rhabdomyolysis (muscle breakdown) releasing myoglobin into the blood, potentially damaging the kidneys.
    • Potassium leakage into the extracellular blood.

    Diagnosis and Treatment

    • Treatment involves immediate discontinuation of the triggering anesthetic agent(s) and administration of dantrolene (muscle relaxant).
    • Supplemental oxygen and cooling measures are vital to reduce the body temperature.
    • Close monitoring is crucial to prevent complications, such as cardiac arrhythmias and kidney damage.
    • Elevated CO2 may also require mechanical ventilation to maintain adequate respiratory function and oxygenation.

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    Description

    This quiz provides an in-depth look at malignant hyperthermia, its triggers, and the physiological changes associated with this life-threatening condition. It covers the normal muscle contraction process and how abnormalities can lead to excessive calcium release, resulting in dangerous symptoms. Test your understanding of this critical medical topic.

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