QuestionSBA
QuestionChoice
The combination of pyrexia, tachycardia and fasciculations in a patient with a family history of a similar presentation suggests malignant hyperthermia. This is a condition seen as a response to certain anaesthetic agents (e.g. suxamethonium or volatile inhaled agents) in genetically susceptible individuals. Suxamethanoium is commonly used in emergency scenarios for rapid sequence induction as in this scenario.
10035027
a
Malignant hyperthermia
QuestionChoice
This is prolonged paralysis which is seen as limited respiratory effort after extubation due to a lack of cholinesterase.
10035028
b
Suxamethonium apnoea
QuestionChoice
This is unlikely to be a normal physiological response, due to the pyrexia, tachycardia and muscle rigidity.
10035031
e
Normal physiological response
QuestionChoice
Whilst this may present with tachycardia after being given medication, it is more likely to present with hypotension and angioedema rather than pyrexia and muscle rigidity.
10035030
d
Anaphylaxis
QuestionChoice
Although this can present with pyrexia and tachycardia, it would be unlikely to occur suddenly after the introduction of an anaesthetic agent and may take longer to occur after a road traffic accident.
10035029
c
Sepsis
Concept
Chapter
2693
3860
Malignant hyperthermia
Topic
177
Anaesthetics and Intensive Care Medicine
19409
Malignant hyperthermia is a rare, life-threatening reaction to certain anesthetics, causing rapid muscle rigidity, high fever, and metabolic disturbances, requiring immediate treatment with dantrolene to prevent serious complications.
A 47-year-old female is in a road traffic accident.

She requires emergency surgery for a ruptured spleen.

Shortly after she is sedated and intubated, she becomes extremely sweaty and her muscles become rigid. Her temperature is recorded at 38.6 degrees Celsius and her heart rate is 118.

Her partner recalls her mother had a similar experience when she had an emergency appendectomy.

What is the most likely diagnosis?
a