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Myasthenia Gravis Exam – Questions & Accurate Solutions (100% Correct)
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Myasthenia Gravis Exam – Questions & Accurate Solutions (100% Correct)
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Myasthenia Gravis Exam – Questions & AccurateSolutions (100% Correct)
Myasthenia Gravis is a chronic disease of what area in the body? Right Ans
- NMJ (post synaptic)
What are the 3 clinical manifestations of myasthenia gravis? Right Ans - 1.
increasing skeletal muscle weakness
2. fatigue of muscles with effort
3. partial restoration of strength/function with rest*
MG is a disorder of the NMJ. What portion of the NMJ is dysfunctional? What
causes this dysfunction? Right Ans - decreased number of working ACh
receptors postsynaptically;
IgE antibodies are found on the post synaptic cleft (these destroy the cleft)
T/F MG patients have decreased ACh release from the pre junctional area of
the NMJ Right Ans - False- the ACh pool is normal
In theory, what plays a central role in the production of IgE antibodies that are
found on the post synaptic cleft that cause MG? How can we treat this?
Right Ans - Thymus gland may have something to do with it;
thymectomy improves symptoms (not curative)
T/F Patients with MG have decreased sensory sensation and altered cognition.
Right Ans - False- MG is a motor disease only
What is the hallmark symptom of MG? Right Ans - generalized weakness
that improves with rest; inability to sustain or repeat muscle contractions
With MG patients, what can accentuate weakness? Right Ans - more
movement = more weakness
, What pre-op medication should we be cautious in using for MG patients?
Why? Right Ans - Versed --> mouth and pharynx muscles are already
weakened, so giving Versed may make them more weak --> apnea
What 6 factors exacerbate MG? Right Ans - 1. infection
2. stress
3. surgery
4. electrolyte imbalance
5. medications
6. pregnancy
What are the 4 treatment options for MG patients? Right Ans - 1.
cholinesterase inhibitors (pyridostigmine)
2. immunosuppressants
3. thymectomy
4. plasmapharesis
What causes cholinergic crisis in treated MG patients? What are the 6
manifestations of this? Right Ans - OD of anticholinesterases:
- muscarinic stimulation
- excessive salivation
- diarrhea
- excessive tearing
- bradycardia
- miosis
- weakness leading to resp failure
What causes myasthenic crisis in treated MG patients? What are the 3
manifestations of this? Right Ans - Underdosing of anticholinesterses:
-pupils normal size
- ptosis
- weakness leading to resp failure
When should you evaluate a MG patient for disease control and medication
stabilization? Right Ans - days before surgery AND immediately prior to
surgery
If MG medications (anticholinesterases) are given to pt the DOS, what should
you expect to happen during the case? Right Ans - - increased vagal reflex
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