What is included in the peripheral nervous system
Everything but the brain and spinal cord lol
Why did the bandana not work?
Cloth is not able to stop microscopic molecules as well as a respirator.
What is the autonomic system composed of?
The autonomic system is composed of the sympathetic and parasympathetic branches. Sympathetic is mostly "fight or flight". Parasympathetic is "rest and digest".
What is a common treatment for organophosphate toxicity?
Atropine and pralidoxime
What are ways to educate farmers on organophosphate poisoning?
Poisoning can be caused by inhalation, ingestion, and dermal contact. Using gloves and respirators during insecticide use is very important.
What are the 3 types of GPCRs
G alpha s: activates adenylate cyclase. Increased cAMP
G alpha q: activates phospholipase C. IP3 induction
G alpha I: inhibition of cAMP
How do organophosphates effect normal physiology of neuronal synapses?
Inhibition of acetylcholinesterase, an enzyme important for acetylcholine breakdown.
Which is not part of the dirty dozen
A. Pear
B. Cherry
C. Broccoli
D. Potatoes
Broccoli
What clinical presentations leads you to believe Mr Hernandez is experiencing a neurological related problems?
Where are organophosphates commonly found in?
Insecticides/ pesticides.
How can you differentiate acute vs chronic exposure of organophosphate poisoning?
Chronic would present as longterm neurological changes. Hallucinations, memory loss, mood changes, and confusion. or death :(
Why is nausea, vomitting and diarrhea seen in Organophosphate poisoning?
Increased Gi motility
What common sympathetic response is affected by organophosphate toxicity?
Increased sweating. Although sweat gland activation is induced by the sympathetic system, they contain acetylcholine receptors.
What are the common clinical presentations of organophosphate toxicity?
DUMBELS
Increased: Defecation, Urination, Miosis, Bronchospasm/bradycardia, emesis, lacrimation, salivation
Why is pralidoxime prescribed along with atropine?
Atropine is a muscarinic antagonist, this would take care of the parasympathetic response. Pralidoxime would regenerate AchE
What divisions of the nervous system controls autonomics. (contain autonomic fibers)
Cranial and sacral control parasympathetic while t1-l3 contain sympathetic fibers.
Is epinephrine a neurotransmitter?
It is technically a derivative of norepinephrine but not directly released in the synapse.
How does the RBC AchE testing work?
It measures the choline level in the blood. Decreased level of choline means there is limited acetylcholine breakdown happening.
Why might you see flaccid paralysis in skeletal muscles after organophosphate poisoning.
This would be due to a depolarization block.
Why is the administration of pralidoxime time sensitive?
Effectively detaches organophosphate before it irreversibly binds. As time goes on, it will irreversibly bind to AChE.
This process is called aging, Enzyme becomes resistant to reactivation.
What kind of receptors does Acetylcholine bind to and what makes them different?
Ach will bind to nicotinic receptors which are ligand gated channels. Muscarinic are GPCR. Nicotinic receptors have a faster response compared to muscarinic.
Why must the myosin light chain in smooth muscle need to be phosphorylated for contraction.
Smooth and cardiac muscle do not contain troponin during the muscle contraction activation.
Mr Hernandez first experienced muscle weakness and then other symptoms such as increased salivation, sweating, and watery eyes etc. What is the reasoning?
Neuromuscular effects would be faster than parasympathetic effects due to the faster response to the increased Ach in the synapse. Ligand gated vs GPCR.
What is the difference between a neuromuscular response and a neuronal synapse response.
Normal neuronal responses are induced by an electrical threshold that begins the action potential. Neuronal synapses have endplate potential thresholds which are ligand based binding to induce an action potential.
Would Mr Hernandez symptoms be different if he was a long term smoker?
Perhaps worse symptoms. Long term effects of smoking increases number of nicotinic receptors. This COULD lead to elevated responses to increased synaptic/ neuromuscular Ach.