Myasthenia Gravis Flashcards
Which of the following is true about Edrophonium?
A. Initial dose of 3mg
B. Reversible AChE inhibitor
C. Atropine is given to reverse the worsening symptoms
D. Any of the options
D. Any of the options
Which of the following is true about Neostigmine?
A. Destroyed by plasma esterases
B. Reversible AChE inhibitor
C. Has a greater effect on skeletal muscles
D. Any of the options
D. Any of the options
All of the following are quaternary amines EXCEPT:
A. Neostigmine
B. Pyridostigmine
C. Edrophonium
D. Physostigmine
D. Physostigmine - tertiary amine
Which of the following is considered as short-acting cholinesterase inhibitors?
A. Edrophonium
B. Neostigmine
C. Pyridostigmine
D. Physostigmine
A. Edrophonium
Which of the following is considered as intermediate-acting cholinesterase inhibitors?
A. Edrophonium
B. Neostigmine
C. Echothiopate
D. Any of the options
B. Neostigmine
Which of the following is considered as long-acting cholinesterase inhibitors?
A. Malathion
B. Neostigmine
C. Echothiopate
D. Any of the options
D. Any of the options (Echothiopate, malathion, parathion)
All organophosphates are generally well absorbed from the skin, lung, guts, conjunctiva, and CNS EXCEPT:
A. Echothiopate
B. Malathion
C. Parathion
D. Any of the options
A. Echothiopate
Which of the following is/are TRUE about long-acting cholinesterase inhibitors?
A. Have limited half-life
B. Reversible AChE inhibitors
C. CNS toxicity is an important component of poisoning with these agents
D. Any of the options
D. Any of the options (A and C are TRUE)
Short and immediate acting - REVERSIBLE
Long acting - IRREVERSIBLE
Which of the following should you opt to use for intermediate-term therapy of MG?
A. Prednisone + Cyclosporine
B. Azathioprine + Mycophenolate mofetil
C. Prednisone + Mycophenolate mofetil
D. Any of the options
A. Prednisone + Cyclosporine
Which of the following should you opt to use for long-term therapy of MG?
A. Prednisone + Cyclosporine
B. Prednisone + Tacrolimus
C. Azathioprine + Mycophenolate mofetil
D. Any of the options
C. Azathioprine + Mycophenolate mofetil
The MOA of this drug includes inhibition of proliferation if lymphocytes but not the proliferation of other cells
Mycophenolate mofetil
This drug is used to reduce the dosage of prednisone to control necessary symptoms
Azathioprine
Which of the following is FALSE about Cyclosporine?
A. Considered as calcineurin inhibitor
B. Inhibits IL-1 and IL-2 receptor productions
C. Works more slowly than Azathioprine and Mycophenolate mofetil
D. Any of the options
C. Works FASTER than azathioprine and mycophenolate mofetil
This drug is a chimeric monoclonal antibody that binds to the CD20 molecule on B lymphocytes
Rituximab
Which of the following drugs is considered to be more effective in MuSK antibody-positive MG?
A. Azathioprine
B. Cyclosporine
C. Rituximab
D. Mycophenolate mofetil
C. Rituximab
This drug is a humanized IgG monoclonal antibody that binds to the C5 complement pathway
Eculuzimab
What drug is contraindication with Azathioprine?
A. Allopurinol
B. Colchicine
C. Rituximab
D. Any of the options
A. Allopurinol
At high doses, this drug eliminates mature lymphocytes but spares hematopoietic precursors
Cyclophosphamide
Which is the first line of drug for MG
Pyridostigmine
MG is characterized more of which of the ff:
A. Benign thymoma
B. Malignant thymoma
C. Thymic hyperplasia
D. Any of the options
C. Thymic hyperplasia (75%)
Problem in airways (asthma) is considered as ________ (obstructive/restrictive) disease.
Obstructive
Problem in lung expansion (pulmonary fibrosis) is considered as ________ (obstructive/restrictive) disease.
Restrictive
Problem in trachea is considered as ________ (obstructive/restrictive) disease.
Obstructive
Edrophonium effects involve all of the ff EXCEPT:
A. Pupillary dilation
B. Increased salivation
C. Bradycardia
D. Any of the options
A. Pupillary CONSTRICTION
This is the specific test for MG
Anti AChR
Most sensitive test for NMJ disorders
ANA
Most sensitive diagnostic test for MG
SFEMG
What disease involves the complaint of fatigue, with tiredness or apathy rather than decreasing muscle power on repeated effort?
Neurasthenia
Which of the following clinical manifestations separate MG from Botulism?
A. Diplopia
B. Reduced salivation
C. Pupillary dilation
D. Any of the options
B. and C.
Which of the ff decreases the acetylcholine release?
A. Potassium
B. Sodium
C. Calcium
D. Magnesium
D. Magnesium
What ocular muscle is involved in ptosis?
Levator palpebrae superioris
What EOM are involved in diplopia?
Superior rectus and Inferior oblique
It is a syndrome that is caused by antibodies that block ACh release by inhibiting a presynaptic CALCIUM channel
LEMS
What is the most sever complication of MG?
Respiratory failure
What type of hypersensitivity is MG?
Type II
Lambert-Eaton syndrome is a neuromuscular junction disorder causing (proximal/distal ________ muscle weakness.
proximal
Lambert-Eaton syndrome is commonly associated with
_________ of the lung and is characterized by muscle weakness of the limbs.
small cell carcinoma
The diagnosis of Lambert-Eaton myasthenic syndrome is established by performing _________ electrodiagnostic study.
repetitive nerve stimulation
_____________ is used for the management of Lambert-Eaton myasthenic syndrome in patients resistant to symptomatic treatment.
Intravenous immunoglobulin
______ is the first line treatment for botulism
Antitoxin (HEPTA, BIG-IV)
