Term
Which of the following drugs is NOT a trigger for MH?
a. halothane
b. sevoflurane
c. isoflurance
d. desflurane
e. succinylcholine
f. Nitrous oxide |
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Definition
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Term
| What is the most specific and sensitive, and considered the earliest sign of MH? |
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Definition
| unexpected, sudden rise in ETCO2 (can be masked by vigorous hyperventilation) |
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Term
| The temperature rises suddenly by ____ to ____ degrees C every ____ minutes |
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Definition
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Term
| True or False; the CO2 absorber will feel hot in MH |
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Definition
| True: Co2 and absorber = exothermic reaction |
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Term
| INITIAL signs of MH include ? (2) |
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Definition
| Tachycardia & Tachypnea (usually blunted by General anesthetics) |
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Term
| What electrolyte abnormality other than hypercalcemia occurs with MH ? |
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Definition
| sudden hyperkalemia (compensation for metabolic acidosis that occurs ) |
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Term
| Survival after treatment for an MH event is threatened by what 2 major complications? |
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Definition
| Myogloinuric renal failure and DIC |
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Term
| A pt s/p MH intra-operatively is tranfered to ICU, you know that they are at risk for re-occurance/rebound MH within what time frame? |
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Definition
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Term
| What drug, when used with volatile agents accelerates the manifestations of MH (symptoms seen w/in 5-10minutes)? |
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Definition
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Term
Which of the following is TRUE regarding MMR?
a. occurs more often in children
b. peak occurance at 8-12 years old
c. rigidity of jaw muscles after succs administration
d. Less commonly; MMR occurs after thiopental and propofol
e. MMR is releived with additional doses of succs or NDMR |
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Definition
a,b,c, d(c=definition of MMR)
additional doses of Succs or NDMR will NOT releive the spasm associated with MMR |
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Term
| What % of people with MMR test positive for MH? |
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Definition
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Term
| True or False; limb rigidity in addition to MMR rules out MH as the cause |
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Definition
| FALSE! If limb rigidity and MMR; association of MH increases |
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Term
| True or False; MMR always indicates MH |
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Definition
| False; possibly d/t myotonic syndrome, TMJ dysfunction, underdosing succs, intubating before succs works, giving succs in presence of fever or elevated plama epi levels) |
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Term
What symptoms (when BOTH are present) can be considered red flags (associated increased incidence) for risk of developing MH?
a. ptosis
b. miosis
c. strabismus
d. nystagmus |
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Definition
a & c
strabismus alone is not associated with MH |
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Term
| At what core temperature should cooling in MH be stopped? |
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Definition
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Term
| What drugs should be avoided when treating tachycardias associated w/MH? |
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Definition
| CCB's: verapamil will react w/dantrolene to cause hyperkalemia |
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Term
| What is the drug of choice to treat VT or VF in MH? |
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Definition
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Term
| What is the dose of dantrolene for MH? |
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Definition
| 2.5mg per kg q 15 min until symptoms resolve (max 10mg/kg) |
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Term
| What is the bicarb given to treat the severe metabolic acidosis that is caused by MH? |
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Definition
| 2-4 meq/kg (versus normal dose 1meq/kg) |
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Term
| Dantrolene must be reconstituded in what? |
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Definition
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Term
| True or False temperature increase is a LATE sign of MH |
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Definition
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Term
| True or False; increased ETCO2 is an EARLY sign of MH |
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Definition
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Term
| What test is the GOLD standard for diagnosing MH? |
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Definition
Halothane/Caffeine muscle biopsy test
(if halothane causes contraction= positive test) |
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Term
| Pt's who test + w/ Halothane/Caffeine bx should be encouraged to be what? |
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Definition
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Term
| T/F: When a known MH causing mutation is identified by genetic testing; it is possible to determine MH susceptibility in other family members by examining the RYR-1 gene for EVERY mutation |
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Definition
| False; only for THAT mutation (there are over 80 mutations) |
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Term
| T/F:pt's who Testnegative for specific gene mutations for MH can be considered MH negative |
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Definition
| False! Can NOT be considered negative; if test positive= high risk for MH |
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Term
| Can General anesthesia (vs. spinal/epidural) be done in mom who is not positive and dad who is? |
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Definition
yes, ONLY TIVA
NO volatiles NO succs |
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Term
Care plan for those at high risk for MH should include?
a. Remove succs from cart
b. anxiolytics
c. change soda lime and circuit
d. flush w/10L oxygen for @ least 20 min (or 10min if FGH changed)
e. core body temp
f. accurate ETCO2 montioring
g. cooling blanket in room
h. MH cart in room
i. 3L COLD fluids in room/nearby
j. ALL of the above |
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Definition
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