NMJ Disorders

Question 1

Myasthenia Gravis

Answer 1

Autoimmune disorder affecting postsynaptic acetylcholine receptors.
More common in females and not very rare (7/10,000)
Present with weakness in a specific muscle
Presents with extraocular weakness or ptosis
Least severe weakness in the morning and worsens as the day progresses.
exacerbations and remissions in symptom pattern
Triggered by sunlight, surgery, immunization, stress, menstruation, infection, meds, etc.
Associated with Thymic abnormalities!!!

Question 2

Lambert-Eaton Myasthenic Syndrome

Answer 2

Impaired ACh release from the motor nerve terminal.
autoantibodies against Voltage Gated Calcium Channels.
Without influx of calcium there is diminished neurotransmitter release.
50% of cases associated with small cell lung cancer in smokers

Question 3

Organophosphate Toxicity

Answer 3

found in many insecticides
Binds to Esteric site of acetylcholinesterase causing muscarinic effects SLUDGE and DUMBELS (have their own card)
Treat with 100% oxygen, usually requiring intubation. Charcoal if recently ingested. wash exposed areas.

Question 4

SLUDGE and DUMBELS

Answer 4

feature of acute organophosphate poisoning
Salivation Diarrhea
Lacrimation Urination
Urinary incontinence Miosis
Diarrhea Bronchospasm
Gastrointestinal cramping Emesis
Emesis Lacrimation
Salivaiton