Auto Immune conditions

Question 1

What is myasthenia Gravis Doctor

Answer 1

autoimmune disorder resulting in insufficient functioning acetylcholine receptors. Antibodies to acetylcholine receptors are seen in 85-90% of cases*

Question 2

What is myasthenia Gravis - patient

Answer 2

In our body we have nerves which send signal from our brains to our muscles. Between nerves we have gaps and we release chemicals that act as a bridge for the nerve signal over that gap. In myasthenia Gravis there is a problem with the bridge meaning the nerve signal does not make it over the gap resulting in the symptoms you’re describing.

Question 3

Key features of Myasthenia Gravis

Answer 3

Muscle fatiguability:

1. Diplopia: extraocular muscle weakness
2. Proximal muscle weakness: face, neck, limb girdle
3. Ptosis
4. Dysphagia
5. Voice weakness

Question 4

Associations of MG

Answer 4

1. Thymomas 15%
2. Thymic hyperplasia
3. Pernicious anaemia
4. Thyroid problems
5. SLE
6. Rheumatoid problems

Question 5

Myasthenia Gravis Investigations

Answer 5

1. Auto-antibodies to acetly-choline receptors (85%-90%)
2. single fibre electromyography
3. CT thorax - exclude thymoma
4. CK - normal

Question 6

Management MG

Answer 6

1. Long-acting anticholinesterase inhibitors e.g. pyridostigmine
2. Immunosuppression: prednisolone initially
3. Thymectomy

Question 7

Symptoms of Myasthenia crisis

Answer 7

1. sudden worsening of symptoms
2. severe swallowing problems
3. Breathing difficulty

Question 8

Management of a myasthenia crisis

Answer 8

1. ABCDE
2. Oxygen
3. plasmapheresis
4. intravenous immunoglobulins