MG

Question 1

What is MG?

Answer 1

Autoimmune disease with autoantibodies to nicotinic acetylcholine receptors, meaning that there is decreased neuromuscular conduction across synapses.
This leads to reduced MUSCLE CONTRACTION

Question 2

How does MG present?

Answer 2

Muscles tire throughout day.
Usually presents as ocular MG with ptosis and diplopia & peek sign.
Fatigueable weakness of extraoccular and bulbar (swallow and chew), neck, lumbar & back.

Question 3

What is a myaesthenic crisis?

Answer 3

weakness and fatigue in respiratory muscles that can be life threatening

Question 4

What causes Myaesthenic crises?

Answer 4

Infection (RTI)
Post surgical
Drug Induced (BBs, penecillamine)

Question 5

How to you investigate MG?

Answer 5

Serum antiAch and MUSK
EMG
Do a CT of the Thymus gland for a Thymoma

Question 6

What age of onset is MG?

Answer 6

Young women (under 50)
Older men (over 50)

Question 7

What are the classes of drug used to treat MG & give an example of each

Answer 7

Anticholinesterases- Pyrostigmine

Immunosupressants- Prednisolone and Azathioprine or Methotrexate (to maintain remission)

Question 8

What supportive treatment is there for MG?

Answer 8

Biphosphonates and PPI

Question 9

What surgery is there for MG

Answer 9

Consider thymectomy

Question 10

How do you treat a MG crisis

Answer 10

Plasmapheresis and IVIg