MG Flashcards
What is MG?
A defect in the nerve conduction at the neuromuscular junction in which ACh does not bind.
What are s/s?
Fatigue & weakness mainly in face, can progress to lungs
Not being able to move or barely able
Worsens over the day esp with use of muscles
Ptosis or diplopia
Eyes>Mouth>Throat>Chest>proximal limbs
What factors worsen s/s?
Emotional upset Viral/Resp infection Thyroid probs Increase in body temp Menses Pregnancy
What diagnostic tests are done?
Tensilon test
ACh receptor antibody titer
Repetitive nerve stimulation test
MRI shows enlarged thymus
What meds are given?
Anticholinesterase drugs inhibit breakdown of ACh
Corticosteroids
Immunosuppressants
IV immune globulin
What are other methods of tx?
Plasmapheresis-filters out antibodies
Thymectomy-remove thymus
When do pts take meds?
On time and before meals
What is recovery like for MG pts?
Recover back to baseline after exacerbations
What complications can arise in MG pts?
Myasthenic Crisis
Cholinergic Crisis
What happens in a Myasthenic Crisis?
Weakness
What caused Myasthenic Crisis?
Undermedicated Infection Med change Surgery Pregnancy Increase in temp
How do we tx Myasthenic Crisis?
Plasmapheresis
IVIG
Resp support/ICU
What happens in a Cholinergic Crisis?
Muscle weakness, n/v
What causes Cholinergic Crisis?
Overdose of anticholinesterase meds
How do we dx Cholinergic vs. Myasthenic Crisis?
Tensilon test, if they worsen then its Cholinergic Crisis
How do we tx Cholinergic Crisis?
Atropine
Resp support & protect airway
