Myasthenia Gravis Flashcards

1
Q

Myasthenia Gravis is a(n)…

A

acquired, autoimmune, progressive disease

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2
Q

Myasthenia Gravis is characterized by?

A

Muscle weakness

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3
Q

Myasthenia Gravis has remissions and exacerbations? True or false?

A

True

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4
Q

What causes flares in MG?

A

Emotional stress, pregnancy, illness, heat

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5
Q

MG peaks within ____ years of diagnosis?

A

2 years

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6
Q

Is a result of…

A

reduction of acetylcholine receptors

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7
Q

Severity varies from what to what?

A

Mild motor neuron disturbances to respiratory failure

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8
Q

MG typically originates where?

A

Face, jaw, and neck

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9
Q

What parts of the body are later affected?

A

Arms and legs

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10
Q

What are the two types of MG?

A

Ocular

Generalized

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11
Q

What are the ocular symptoms of MG?

A

Ptosis

Diplopia

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12
Q

What is ptosis?

A

Droopy eyes, can be uni/bilateral, can switch eyes

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13
Q

What is diplopia?

A

Double vision

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14
Q

What are bulbar symptoms of MG?

A

Dysarthria
Dysphagia
Fatigable chewing

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15
Q

What is dysarthria?

A

“Marbled” speech

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16
Q

Diagnosis of MG depends on….

A

ocular or general symptoms

17
Q

What are the tests to diagnose MG?

A

Tensilon Test
Ice Pack Test
Serologic Test- Autoantibodies
Nerve conduction test (EMG)

18
Q

Explain tensilon test…

A

Tensilon is an acetylcholinesterase inhibitor that is given IV; onset is 30-45 seconds, duration of action is 5-10 minutes; watch the eyelids, ptosis will improve if MG

19
Q

Explain ice pack test…

A

surgical glove filled with ice is placed on eyelid(s) for 2 minutes; when ice is removed, ptosis will immediately improve if MG

20
Q

Which antibodies does the serologic test show?

A
Acetylcholine receptor (AChR-Ab) antibodies
Muscle-specific tyramine kinase (MuSK) antibodies
21
Q

Drug therapy for MG

A
Acetylcholinesterase inhibitors
     >first line treatment
     >pyridostigmine bromide
Immunotherapeutics
     >predisone
     >azathioprine
     >cyclosporine
22
Q

Short term treatments are used…

A

until other medications take effect
prior to surgery
for myasthenic crisis

23
Q

What are the short term treatments for MG?

A
Intravenous immunoglobulin (IVIG)
Plasmapheresis (plasma exchange)
24
Q

What is intravenous immunoglobulin (IVIG)?

A

Injection of nonspecific antibody (immunoglobulin) that dials down the immune system’s production of its own antibodies

25
Q

What is plasmapheresis?

A

Plasma exchange; antibodies are removed from plasma to decrease symptoms; 6 exchanges over a 2-week period

26
Q

MG Surgical Management

A

Thymectomy- removal of thymus (thymus enhances AChR antibodies); done early in diagnosis

27
Q

Hospital admissions for MG are related to…

A

respiratory tract infection

acute myasthenic crisis

28
Q

Teach:

A
Balanced diet (semi-solid is best)
What causes flairs
Medicine regimen
Complications of MG
Complications of therapy
Support groups available
29
Q

Difference between myasthenic crisis and cholinergic crisis?

A

Myasthenic crisis:
> Caused by NOT ENOUGH anticholinesterase drugs or some type of infection
Cholinergic Crisis
> Caused by TOO MANY anticholinesterase drugs

30
Q

Features common to both myasthenic crisis and cholinergic crisis?

A
Apprehension
Restlessness
Dyspnea
Dysphagia
Generalized weakness
Respiratory failure
31
Q

Unique features of myasthenic crisis?

A

Increase in VS
Bowel/ bladder incontinence
Absence of cough/ swallow reflex
Improvement of symptoms with tensilon test

32
Q

Unique features of cholinergic crisis?

A
Flaccid paralysis
Hypersecretions (saliva, sweat, tears)
N/V/D
Abdominal cramps
Worsening symptoms with tensilon test