42. Diseases of the neuromuscular junction. Toxicosis, tetanus, botulism Flashcards

1
Q

included in neuromuscular junction

A

axon terminal
synaptic cleft
endplate

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2
Q

general clinical signs of diseases of neuromuscular junction

A

autonomic signs
decreased muscle tone
decreased segmental spinal reflexes
cranial nerve deficits
tetraplegia
weakness

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3
Q

Presynaptic disorders

A

less ACh is released from the terminal
LMN type deficits

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4
Q

Clinical signs of Presynaptic disorders

A

Hypotonia
hyporeflexia
dysphagia
dysphonia

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5
Q

Post synaptic disorders

A

Problems related to Ach specifically
exercise induced weakness

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6
Q

Name of Postsynaptic disorder

A

myasthenia gravis

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7
Q

Acquired myasthenia gravis

A

Autoantibodies produced against ACh receptors on post synaptic terminal
decreased number of functional receptors

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8
Q

Congenital myasthenia gravis

A

ACh receptor deficiency/ abnormality on the post synaptic membrane of the NMJ

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9
Q

Forms of myasthenia gravis

A

Generalised
Focal
Fulminant

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10
Q

Generalised myasthenia gravis

A

normal at rest
exercise induced weakness
paresis
megaoesophagus
ptyalism

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11
Q

Focal myasthenia gravis

A

weakness of an isolated muscle group

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12
Q

fulminant myasthenia gravis

A

progressive symptoms
tetraparesis
diffuse weakness

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13
Q

Diagnosis of myasthenia gravis

A

Tensilon test
ACh-Rez Ab - determines the autoantibodies
Electrodiagnosis

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14
Q

Treatment of myasthenia gravis

A

Acetylcholinesterase inhibitors - pyridostigmine
immunosuppression

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15
Q

Enzymatic disorders

A

Acetylcholinesterase inhibitors
Vegetative overstimulation

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16
Q

Clinical signs of Enzymatic disorders

A

Exercise intolerance
muscle tremor
stiff gait

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17
Q

exercise induced collapse of labradors

A

similar symptoms to myasthenia gravis
after prolonged activity –> overheat –> fatigue –> flaccid paresis

18
Q

Toxicosis affect NMJ

A

Organophosphate & carbamate
Strychinine poisoning
ivermectin toxicosis
lead toxicosis

19
Q

Organophosphate & carbamate

A

found in insecticides
inactivation of acetylcholinesterase

20
Q

Organophosphate & carbamate
clinical signs

A

salivation
lacrimation
bradycardia

21
Q

Organophosphate & carbamate
treatment

A

atropine
pralidoxime

22
Q

Strychinine poisoning

A

glycine antagonist

23
Q

Strychinine poisoning
clinical signs

A

drawn together ears
saw horse position
hypersensitivity
opisthotonos
seizure
apnoea

24
Q

ivermectin toxicosis

A

GABA agonists
collies

25
Q

ivermectin toxicosis
clinical signs

A

salivation
mydriasis
vomiting
tremors
bradycardia
ataxia
seizures

26
Q

ivermectin toxicosis
treatment

A

symptomatic

27
Q

lead toxicosis
clinical signs

A
  • Lethargy
  • GI symptoms
  • Inappetence
  • Depression
  • Weight loss
    -Seizures
  • Haematologic alterations
  • Ataxia
  • Blindness
  • Anorexia
  • Myoclonus
  • Hysteria
28
Q

lead toxicosis
diagnosis

A

measurement of Pb in blood, urine, liver and kidney

29
Q

lead toxicosis
treatment

A

removal of lead product
Ca-EDTA IV
anticonvulsant
diuretics
GCC

30
Q

other toxicosis

A

metaldehyde toxicosis
pyethrins
ethylene glycol

31
Q

Tetanus
pathomechanism

A

cl. tetani enters wound –> anaerobic environment –> neurotoxin production

32
Q

Tetanus neurotoxin causes

A

inhibits glycine & GABA release –> spasm

33
Q

forms of Tetanus

A

focal
generalised

34
Q

Clinical signs of Tetanus

A

extensor rigidity
rictus grin
dysphagia
resp muscle spasm
dyspnoea
salivation
increased muscles tone
muscle spasm
tachypnoea

35
Q

Treatment of Tetanus

A

wound debridement
tetanus antitoxin
AB
muscle relaxant - acp, diazepam

36
Q

Botulism
cause

A

Cl. botulinum
uncooked mead, rotten carcass, spoiled feed

37
Q

Botulism
pathomechanism

A

toxin irreversibly cleaves the protein that docks ACh to the presynaptic membrane –> decreases Ach

38
Q

Clinical signs of Botulism

A

Acute paresis
facial paralysis
tachycardia
bradcardia
urinary retention
megaoesophagus
flaccid paralysis
dysphonia
ileus
mydriasis
dry eye
dysphagia
death

39
Q

Diagnosis of Botulism

A

toxin detection

40
Q

Treatment of Botulism

A

Emetic - apomorphine
Supportive care
not AB
Antitioxin
Good prognosis