An MH history challenge
Sometimes in our constant concern about the future we overlook the past.
I hope you find this quiz to be interesting and informative as well.
1. In what country was the first case of MH described?
a.
b.
c.
d.
e.
f.
2. Prior to the advent of dantrolene what drug was suggested as effective for treating MH?
a. Barbiturates
b. Lidocaine
c. Procaine
d. Aspirin
3. Dantrolene is a molecule close in structure to which of the following:
a. Epinephrine
b. Cortical
c. Digoxin
d. Dilantin
e. Curare
4. The first international workshop on MH was held in what city?
a.
b.
c.
d.
e.
5. Which of the following people in the history of MH were NOT anesthesiologists?
a. Beverly Britt
b. R.A. Gordon
c. Michael Denborough
d. John Ryan
e. Gerald Gronert
6. In what country was the efficacy of dantrolene first shown in animals?
a.
b.
c.
d.
e.
7. At first MH was thought to be related to an abnormality in which anatomic structure?
a. Skeletal muscle
b. Hypothalamus
c. Mitochondria
d. Thyroid gland
e. Adrenal gland
8. The first definitive diagnostic test for MH susceptibility in humans was:
a. Histologic examination of muscle
b. Contracture response of biopsied muscle to caffeine
c. Contracture response of biopsied muscle to halothane
d. Response to halothane administration
9. What is one major difference between MH in susceptible swine and MH in humans?
a. Inheritance in swine is autosomal recessive
b. Swine only trigger with “stress”
c. Genetic changes in swine are associated with ryanodine receptor gene
d. Curare is a trigger for MH in swine
10. In addition to swine naturally occurring MH has been described and studied in all but which animals?
a. Dog
b. Horse
c. Elk
d. Worms (specifically C. Elegans)
e. Rat
11. In which medical journal was the first case of what became known as MH first described in the early 1960s?
a. Anesthesiology
b. British Medical Journal
c.
d. Lancet
e. Anesthesia and Intensive Care
12. When, approximately, were both the European MH group and MHAUS formed?
a. Mid 1970s
b. Early 1980s
c. Late 1980s
d. Mid 1990s
e. None of the above
13. Which company first introduced dantrolene (Dantrium) in 1979?
a. Pfizer
b. Organon
c.
d. Procter and Gamble Pharmaceuticals
e. Elan Pharma
14. Which pharmacologist who played an important role in developing tests for MH also made important contributions to another anesthesia drug related abnormal response?
a. Beverly Britt
b. F. Richard Ellis
c. Werner Kalow
d. Paul Bianchi
e. Russell Van Dyke
5. Michael Denborough was consulted on the first case of MH because the patient described a family history of unexpected deaths during anesthesia. Denborough is geneticist.
6.
7. Most early theories related to MH centered around the temperature controlling site in the brain, the hypothalamus, although “uncoupling” of mitochondrial oxidative phosphorylation was also suggested.
8. The first studies to define the abnormal response of skeletal muscle as a diagnostic test for MH were described by Kalow and Britt in relation to caffeine. It was Dr. Richard Ellis who suggested that halothane be used as part of the test
9. MH differs from human MH because it is inherited in swine as an autosomal recessive. There are also other differences in clinical manifestation especially ease of triggering with stress.
10. Reports of MH have been described in all the animals except the rat. Maybe no one has looked hard enough. In elk and other wild animals, an MH like syndrome called “capture myopathy” characterized by similar signs as in MH have been described.
11. The first report of what will prove to be MH was a letter to the editor in the journal Lancet in 1961
12. MHAUS was formed in 1981, EMHG in 1983, although scientists in
13. Dantrolene was developed in the company Norwich Eaton Pharmaceuticals, located in
14. Werner Kalow (see an article about him in the summer 2008 issue of the Communicator) was the pharmacologist who worked with Dr. Britt on the contracture test for MH. He was well known as one of the founders of the science of pharmacogenetics and described atypical pseudocholinesterase.
Russell Van Dyke was a chemist who worked on the biochemistry of halothane hepatitis, among other things.
Paul Bianchi was a pharmacologist who characterized the whole muscle contracture responses to ryanodine and local anesthetics including procaine.
