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

Question 1

included in neuromuscular junction

Answer 1

axon terminal
synaptic cleft
endplate

Question 2

general clinical signs of diseases of neuromuscular junction

Answer 2

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

Question 3

Presynaptic disorders

Answer 3

less ACh is released from the terminal
LMN type deficits

Question 4

Clinical signs of Presynaptic disorders

Answer 4

Hypotonia
hyporeflexia
dysphagia
dysphonia

Question 5

Post synaptic disorders

Answer 5

Problems related to Ach specifically
exercise induced weakness

Question 6

Name of Postsynaptic disorder

Answer 6

myasthenia gravis

Question 7

Acquired myasthenia gravis

Answer 7

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

Question 8

Congenital myasthenia gravis

Answer 8

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

Question 9

Forms of myasthenia gravis

Answer 9

Generalised
Focal
Fulminant

Question 10

Generalised myasthenia gravis

Answer 10

normal at rest
exercise induced weakness
paresis
megaoesophagus
ptyalism

Question 11

Focal myasthenia gravis

Answer 11

weakness of an isolated muscle group

Question 12

fulminant myasthenia gravis

Answer 12

progressive symptoms
tetraparesis
diffuse weakness

Question 13

Diagnosis of myasthenia gravis

Answer 13

Tensilon test
ACh-Rez Ab - determines the autoantibodies
Electrodiagnosis

Question 14

Treatment of myasthenia gravis

Answer 14

Acetylcholinesterase inhibitors - pyridostigmine
immunosuppression

Question 15

Enzymatic disorders

Answer 15

Acetylcholinesterase inhibitors
Vegetative overstimulation

Question 16

Clinical signs of Enzymatic disorders

Answer 16

Exercise intolerance
muscle tremor
stiff gait

Question 17

exercise induced collapse of labradors

Answer 17

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

Question 18

Toxicosis affect NMJ

Answer 18

Organophosphate & carbamate
Strychinine poisoning
ivermectin toxicosis
lead toxicosis

Question 19

Organophosphate & carbamate

Answer 19

found in insecticides
inactivation of acetylcholinesterase

Question 20

Organophosphate & carbamate
clinical signs

Answer 20

salivation
lacrimation
bradycardia

Question 21

Organophosphate & carbamate
treatment

Answer 21

atropine
pralidoxime

Question 22

Strychinine poisoning

Answer 22

glycine antagonist

Question 23

Strychinine poisoning
clinical signs

Answer 23

drawn together ears
saw horse position
hypersensitivity
opisthotonos
seizure
apnoea

Question 24

ivermectin toxicosis

Answer 24

GABA agonists
collies

Question 25

ivermectin toxicosis clinical signs

Answer 25

salivation mydriasis vomiting tremors bradycardia ataxia seizures

Question 26

ivermectin toxicosis treatment

Answer 26

symptomatic

Question 27

lead toxicosis clinical signs

Answer 27

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

Question 28

lead toxicosis diagnosis

Answer 28

measurement of Pb in blood, urine, liver and kidney

Question 29

lead toxicosis treatment

Answer 29

removal of lead product Ca-EDTA IV anticonvulsant diuretics GCC

Question 30

other toxicosis

Answer 30

metaldehyde toxicosis pyethrins ethylene glycol

Question 31

Tetanus pathomechanism

Answer 31

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

Question 32

Tetanus neurotoxin causes

Answer 32

inhibits glycine & GABA release --> spasm

Question 33

forms of Tetanus

Answer 33

focal generalised

Question 34

Clinical signs of Tetanus

Answer 34

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

Question 35

Treatment of Tetanus

Answer 35

wound debridement tetanus antitoxin AB muscle relaxant - acp, diazepam

Question 36

Botulism cause

Answer 36

Cl. botulinum uncooked mead, rotten carcass, spoiled feed

Question 37

Botulism pathomechanism

Answer 37

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

Question 38

Clinical signs of Botulism

Answer 38

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

Question 39

Diagnosis of Botulism

Answer 39

toxin detection

Question 40

Treatment of Botulism

Answer 40

Emetic - apomorphine Supportive care not AB Antitioxin Good prognosis