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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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submitted by haliburton(74),

"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 +  

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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.

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