Questions · Malignant Hyperthermia
11 questions, 0 approved. Approve them one at a time — a quiz shows nothing you have not.
Recall — derived from a kept point
A resident says fever is the cardinal sign of malignant hyperthermia and that its absence argues against the diagnosis. Using the North American registry data, what is wrong with that reasoning, and where does temperature actually sit in the sequence?
Answer: Temperature abnormality was among the first three signs in 63.5% of episodes — common, but neither invariably first nor universal, and the median maximum temperature was 39.1°C rather than the extreme values often quoted. Hypercarbia, sinus tachycardia and masseter spasm were the frequent initial signs. Those signs are available earlier than a temperature is, which is why the registry data argue against waiting for fever to act.
Temperature abnormality was common but neither first nor universal — a third of episodes did not have it among their first three signs. It should not be required before treating.
Source claim: In 63.5% of registry malignant hyperthermia episodes, temperature abnormality was the first to third sign, with a median maximum temperature of 39.1°C, while frequent initial signs were hypercarbia, sinus tachycardia or masseter spasm.
Larach et al., Clinical presentation, treatment, and complications of malignant hyperthermia in North America 1987-2006, Anesth Analg 2010
recall · CA-2 · phrased by llm
This guideline recommends discontinuing triggering agents and administering intravenous dantrolene at 1-___ mg/kg as essential steps in malignant hyperthermia.
Answer: 2
This guideline recommends discontinuing triggering agents and administering intravenous dantrolene at 1-2 mg/kg as essential steps in malignant hyperthermia.
JSA guideline for management of malignant hyperthermia in 2025 · PMID 41504952
recall · CA-1 · phrased by derived
This retrospective cohort and systematic review found RYR1 or CACNA1S variants in ___% of patients with exertional rhabdomyolysis, suggesting such patients may have increased malignant hyperthermia susceptibility even without prior adverse anesthetic reactions.
Answer: 78
This retrospective cohort and systematic review found RYR1 or CACNA1S variants in 78% of patients with exertional rhabdomyolysis, suggesting such patients may have increased malignant hyperthermia susceptibility even without prior adverse anesthetic reactions.
Malignant hyperthermia susceptibility in patients with exertional rhabdomyolysis: a retrospective cohort study and updated systematic review · PMID 28326467
recall · CA-1 · phrased by derived
The JSA guideline recommends discontinuing triggering agents and administering intravenous dantrolene initially at 1-___ mg/kg for malignant hyperthermia.
Answer: 2
The JSA guideline recommends discontinuing triggering agents and administering intravenous dantrolene initially at 1-2 mg/kg for malignant hyperthermia.
JSA guideline for management of malignant hyperthermia in 2025 · PMID 41504952
recall · CA-1 · phrased by derived
This 2025 Japanese Society of Anesthesiologists guideline recommends treating suspected malignant hyperthermia by immediately stopping triggering agents and administering an initial intravenous dantrolene dose of 1-___ mg/kg, reflecting a higher initial dose based on international standards.
Answer: 2
This 2025 Japanese Society of Anesthesiologists guideline recommends treating suspected malignant hyperthermia by immediately stopping triggering agents and administering an initial intravenous dantrolene dose of 1-2 mg/kg, reflecting a higher initial dose based on international standards.
JSA guideline for management of malignant hyperthermia in 2025 · PMID 41504952
recall · CA-1 · phrased by derived
The point with one number taken out. No model wrote any of this: the stem is the sentence you reviewed, minus a digit, and the paper it came from is named beneath it.
Open prompts
Walk me through your setup for this before we start.
open · CA-1 · phrased by derived
What are you watching on the monitor that would tell you this is going wrong?
open · CA-1 · phrased by derived
What is your first move if it does?
open · CA-1 · phrased by derived
What would you want ready in the room before induction?
open · CA-1 · phrased by derived
Questions only — nothing here asserts anything, which is why a model is allowed to phrase them. Where no model was reachable these are the level defaults.