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sav NUR 405 final exam w6 content > Myasthenia Gravis > Flashcards

Myasthenia Gravis Flashcards

1
Q

Myasthenia Gravis is …
acquired or genetic?
autoimmune?
progressive or stable?
neurodegenerative disease or not?

A

acquired,
autoimmune,
progressive disease
not

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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

can Emotional stress, pregnancy, illness, and heat, cause flares in MG?

A

yes

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5
Q

MG peaks within ____ years of diagnosis?

A

2 years

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6
Q

MG is a result of what issue/problem occuring in the body?

A

reduction of acetylcholine receptors

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7
Q

Severity varies from Mild ______ ______ disturbances to respiratory ______

A

Mild motor neuron disturbances to respiratory failure

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8
Q

MG typically originates where? (3)

A

Face, jaw, and neck

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9
Q

What parts of the body are later affected? (2)

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

(2) What are the ocular symptoms of MG?

A

Ptosis
Diplopia

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12
Q

What is ptosis?

uni or bilateral?

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? (3)

A

Dysarthria
Dysphagia
Fatigable chewing

Bulbar symptoms are a result of impaired function in the lower cranial nerves, which control the muscles used for swallowing, chewing, speaking, and moving the head and neck.

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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? (4)

A

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

18
Q

Explain tensilon test…
Tensilon is a(n) ________ inhibitor that is given (route) _______;
onset is ______ seconds,
duration of action is ______ minutes;
watch the ________,
(condition) _____ will improve/worsen if MG?

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…
surgical glove filled with ice is placed on eyelid(s) for ___ minutes;
when ice is removed,

(condition) _________ will immediately improve/worsen if MG?

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

(2)
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 (2)

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

Short term treatments are used…(3)

A

until other medications take effect
prior to surgery
for myasthenic crisis

23
Q

What are the short term treatments for MG? (2)

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 (1)

A

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

27
Q

___________ - removal of thymus
(thymus enhances ____________); done early in diagnosis

A

Thymectomy

AchR antibodies

28
Q

Hospital admissions for MG are related to… (2)

A

respiratory tract infection
acute myasthenic crisis

29
Q

Teach:

A 
Balanced diet (semi-solid is best)
What causes flairs
Medicine regimen
Complications of MG
Complications of therapy
Support groups available
30
Q

Difference between myasthenic crisis and cholinergic crisis?

caused by…

A

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

31
Q

Features common to both myasthenic crisis and cholinergic crisis?

A 
Apprehension
Restlessness
Dyspnea
Dysphagia
Generalized weakness
Respiratory failure
32
Q

Unique features of myasthenic crisis?

A

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

33
Q

Unique features of cholinergic crisis?

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

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