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Myasthenia Gravis: Questions & Correct Answers
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Myasthenia Gravis: Questions & Correct Answers
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Myasthenia Gravis: Questions & Correct Answers2 types of myasthenia gravis Right Ans - ocular and generalized
what is myasthenia gravis Right Ans - serious/grave muscle weakness
pathophysiology of myasthenia gravis Right Ans - antibodies attack
acetylcholine receptor sites
impaired transmission of impulses across myoneural junction
fewer receptors are available for stimulation which results in involuntary
muscle weakness that escalates with continued activity
normal acetylcholine reactions at nerve terminal/myoneural junction
Right Ans - acetylcholine attaches to receptor sites on motor endplate and
stimulates muscle contraction
continuous binding of acetylcholine to receptor site is required for muscular
contraction to be sustained
clinical manifestations of myasthenia gravis Right Ans - motor disorder
with no effect on sensation and coordination
generalized weakness affecting all extremities, intercostal muscles
facial muscle weakness
laryngeal involvement
ocular muscle dysfunction
why is it an issue that MG can cause intercostal muscles? Right Ans - risk
for respiratory failure
laryngeal weakness is a manifestation of MG. What might this look like?
Right Ans - bulbar symptoms (throat weakness)
dysphonia
dysphagia
ocular muscle dysfunction occurs in 80% of MG patients. What might this look
like? Right Ans - diplopia (double vision)
ptosis
strabismus (cross eyes)
, tests to diagnose MG Right Ans - tensilon test (ONLY ONE THAT
DIAGNOSES)
ice test
EMG
repetitive nerve stimulation
MRI
Labs
tensilon test Right Ans - edrophonium chloride IV (acetylcholinesterase
inhibitor) is injected and muscle weakness and ptosis resolve for about 5
minutes
Immediate improvement in muscle strength after administration is a positive
test which confirms diagnosis
edrophonium chloride IV (acetylcholinesterase inhibitor) is given during the
tensilon test. What med should be at the bedside to control side effects? (and
what are those side effects?) Right Ans - Atropine IV
bradycardia, systole, bronchoconstriction, sweating, cramping
ice test Right Ans - alternative to tensilon test
ice pack is held over patient's eye for one 1-5 minutes
ptosis temporarily resolves
does not alone confirm diagnosis
why would someone use the ice test instead of the tensilon test? Right Ans
- indicated for those with cardiac conditions who cant use edrophonium
less expensive, less invasive
how does repetitive nerve stimulation diagnose MG? Right Ans - repeated
stimulation of muscle depletes ACh and muscle contraction decreases
does not alone confirm diagnosis
MRI of person with MG Right Ans - can detect thymus hyperplasia (site of
acetylcholine receptor antibody production)
Thymus enlarged in 85% of patients with MG
does not alone confirm diagnosis
diagnostic lab for MG Right Ans - acetylcholine antibodies present
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