Botulism, tetanus, and drug induced myopathies

Question 1

Clostidium botulinum?

Answer 1

gram positive rod that forms spores
after ingesting toxin/wound, nausea vomit dizziness, cranial palsy double vision swallowing difficult, respiratory paralysis

Question 2

Neurotoxins with botulinum?

Answer 2

A, B and E in humans

prevents release of acetylcholine from the alpha-motor neuron, muscle cannot receive signal, flaccid paralysis

Question 3

Heavy chain B/ light chain a?

Answer 3

B binds to the toxin to the specific types of axon terminals
A part is active, cleaves and released into cytoplasm

degrades snare protein
prevents neuro-secretory vesicles from docking/fusing with the nerve synapse plasma membrane and releasing their NT

Question 4

Infant botulism?

Answer 4

floppy baby syndrome
baby’s immature immune system and inability to process toxin in intestinal tract
Symptoms
-general muscle fatigue, weak sucking, ptosis, inactivity, constipation

Diagnosis- from stool

Question 5

Tetanus?

Answer 5

from release of toxin by Clostridium tetani

headache, jaw cramp, tightening, stiffness, seizures, high mortality

Question 6

Clostridium tetani?

Answer 6

virulence factor- tetanospasmin

suppress release of GABA (inhibitory nt) signals are unopposed and constant stim to contract

Question 7

Pathogenesis of clostridium tetani?

Answer 7

CNS (PNS, spinal cord, brainstem)
toxin is taken up into the nerve axon and transported across the synaptic junctions, until it reaches the CNS where it is bound by the heavy chain at the presynaptic junctions of the inhibitory motor nerve endings

Question 8

Diagnose tetani?

Answer 8

gram pos motile rod with terminal spores

Question 9

Treat tetani?

Answer 9

antitoxin, debride tissue, Penicillin

Question 10

Prevention tetani?

Answer 10

DTaP

tetanus booster

Question 11

Actue Alcohol induced myopathy?

Answer 11

longstand alcohol
men more common
nontraumatic rhabdomyolysis
dose related, damage muscle and usually recover

Question 12

Chronic alcohol induced myopathy?

Answer 12

women more common
diffuse muscle atrophy
muscle pain usually absent

Question 13

Cocaine induced myopathy?

Answer 13

usually for other problems, incidental

increase sympathetics, vasoconstrict skeletal muscle ischemia

Question 14

Glucocorticoids induced myopathy?

Answer 14

common cause of drug induced
direct catabolic effects
affects intermediary metabolism that provides amino acids as a substrate for gluconeogenesis
may increase muscle degredation/atrophy

Question 15

Lipid lowering drugs induced myopathy?

Answer 15

primarily the statins

myalgias to myostitis to overt rhabdomy

Question 16

Zidovudine induced myopathy?

Answer 16

causes mitochondrial myopathy
disrupt mitochondrial DNA
disrupt oxphos leads to energy loss and increase electron leakages, production of ROS