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NBME 21 Answers

nbme21/Block 2/Question#2

A 4-year-old girl is conscious but unable to ...

Pseudocholinesterase deficiency

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 +8  upvote downvote
submitted by haliburton(74),

https://ghr.nlm.nih.gov/condition/pseudocholinesterase-deficiency

"People with pseudocholinesterase deficiency may not be able to move or breathe on their own for a few hours after [fast-acting drugs, such as succinylcholine and mivacurium] are administered.

ragacha  THX +  




 +1  upvote downvote
submitted by d_holles(31),

Also, I think what is key is to realize that injuring CN X ('intraoperative CN X injury') does not lead to diaphragm paralysis, only phrenic nerve injury would do that.

amboss.com/us/CN+X+injury

Furthermore, the other options ('idiosyncratic rxn to sevoflurane' and 'ryanodine receptor defect') are for malignant hyperthermia, NOT unable to breath spontaneously.