Question

A 50-year-old chronic smoker comes to your clinic complaining that he has noticed he is having more difficulty rising from a chair, climbing stairs, and walking. He has always been very active and is in good physical health. He first noticed that his legs felt weaker about a year ago. He thought it was just part of normal aging, but he has noticed that his weakness has slowly progress. He states that occasionally his legs ache. You inquire about other autonomic symptoms and he indicates that he also has xerostomia. You suspect that he may have Lambert-Eaton myasthenic syndrome (LEMS). What causes muscle weakness in patients with LEMS? If you could record from presynaptic motor neuron terminals, what changes would you expect to find in terms of presynaptic Ca2+, Na+, and K+ influxes? If you could record from the affected skeletal muscles in the legs, what changes would you expect to find in terms of miniature endplate potentials, endplate potentials, and success rates of action potentials in response to motor nerve stimulation? Use drawings to illustrate your predictions. LEMS can be treated with 3,4-diaminopyridine. Explain how this medication alters skeletal muscle physiology to reduce muscle weakness. Use drawings to illustrate your predictions. Explain why hypermagnesemia and calcium channel blockers can exacerbate muscle weakness in patients with LEMS? Explain what causes xerostomia in this patient. Include the nerves, neurotransmitters, receptors, and tissue involved in your explanation. Since the patient has symptoms of xerostomia, what other symptoms should be looked for in this patient? What other medications could help reduce the patient’s muscle weakness and xerostomia. Explain how these medications work. What other diseases are associated with LEMS?

          A 50-year-old chronic smoker comes to your clinic complaining
that he has noticed he is having more difficulty rising from a
chair, climbing stairs, and walking. He has always been very active
and is in good physical health. He first noticed that his legs felt
weaker about a year ago. He thought it was just part of normal
aging, but he has noticed that his weakness has slowly progress. He
states that occasionally his legs ache. You inquire about other
autonomic symptoms and he indicates that he also has xerostomia.
You suspect that he may have Lambert-Eaton myasthenic syndrome
(LEMS).
What causes muscle weakness in patients with LEMS?
If you could record from presynaptic motor neuron terminals,
what changes would you expect to find in terms of presynaptic
Ca2+, Na+, and
K+ influxes?
If you could record from the affected skeletal muscles in the
legs, what changes would you expect to find in terms of miniature
endplate potentials, endplate potentials, and success rates of
action potentials in response to motor nerve stimulation? Use
drawings to illustrate your predictions.
LEMS can be treated with 3,4-diaminopyridine. Explain how this
medication alters skeletal muscle physiology to reduce muscle
weakness. Use drawings to illustrate your predictions.
Explain why hypermagnesemia and calcium channel blockers can
exacerbate muscle weakness in patients with LEMS?
Explain what causes xerostomia in this patient. Include the
nerves, neurotransmitters, receptors, and tissue involved in your
explanation.
Since the patient has symptoms of xerostomia, what other
symptoms should be looked for in this patient?
What other medications could help reduce the patient’s muscle
weakness and xerostomia. Explain how these medications work.
What other diseases are associated with LEMS?

a 50 year old chronic smoker comes to your clinic complaining that he has noticed he is having more difficulty rising from a chair climbing stairs and walking he has always been very active 78555

Added by Corey H.

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