Myasthenia Gravis

Question 1

myasthenia gravis is what type of disorder

Answer 1

autoimmune disorder - body produces antibodies that attacking itself

Question 2

dx for myasthenia gravis

Answer 2

blood test to test for antibodies

Question 3

what is a neuromuscular junction

Answer 3

area of communication between brain and muscle to cause muscle contraction (movement)

Question 4

what is acetylcholine

Answer 4

a neurotransmitter

Question 5

what is acetylcholine responsible for

Answer 5

muscle contraction (movement) and helps with cognition/memory

Question 6

myasthenia gravis only effects the

Answer 6

neuromuscular junction -

Question 7

in myasthenia gravis there is a deficit in

Answer 7

a deficit in acetylcholine binding to the muscle fiber

Question 8

does someone with myasthenia gravis have any cognition problems

Answer 8

no - because its only at the neuromuscular junction

Question 9

s/s of myasthenia gravis

Answer 9

weakness of skeletal muscles - decreased muscle strength of face and upper extremities (most commonly eyes (ocular and face)
nodules (benign masses on ultrasound)
voice becomes nasally, fades, slurred speech

Question 10

in myasthenia gravis you have periods of remissions and exacerbation’s, t or f

Answer 10

true

Question 11

your chances of getting myasthenia gravis increases with age, t or f

Answer 11

false - earlier onset (teens, twenties)

Question 12

best way to dx myasthenia gravis - antibody involved

Answer 12

anti-acetylcholine antibody

Question 13

what other body part is involved in myasthenia gravis

Answer 13

thymus

Question 14

what is the thymus responsible for

Answer 14

help produce antibodies

Question 15

what is noted on thymus in myasthenia gravis

Answer 15

benign nodules on their thymus - identifiable by ultrasound

Question 16

what can keep people in a prolonged state of remission with myasthenia gravis

Answer 16

removal of the thymus

Question 17

**how do we test for weakness of the face in myasthenia gravis

Answer 17

ocular fatigue-ability gaze - look up/straight for 2-3 minutes, within 10 sec gaze falls down
peek sign - while squinting try and open eyes - dont have strength to keep eyes closed

Question 18

myasthenia gravis r/t acetylcholine production

Answer 18

no deficit in acetylcholine production - deficit is in receptor sites to bind it to the neuromuscular junction

Question 19

trt for myasthenia gravis

Answer 19

give meds to increase acetylcholine

Question 20

what do we worry about with myasthenia gravis

Answer 20

airway protection, risk for aspiration, swallowing/chewing

Question 21

is myasthenia gravis a progressive disease

Answer 21

no - stays the same - treatable - can succumb to secondary issues

Question 22

is myasthenia gravis life threatening

Answer 22

no

Question 23

when symptoms are very bad what is the term

Answer 23

myasthenia crisis

Question 24

s/s of myasthenia crisis

Answer 24

risk for airway issues, choking hazard, severe muscle weakness

Question 25

what causes a myasthenia crisis

Answer 25

insult, trauma or stress on the body (cold, surgery, pregnancy)

Question 26

what is a cholinergic crisis

Answer 26

excess of acetylcholine and the neuromuscular junction site

Question 27

what can cause a cholinergic crisis

Answer 27

over-medication

Question 28

s/s of cholinergic crisis

Answer 28

respiratory failure

Question 29

how would we know if pt in ER is having a myasthenia vs cholinergic crisis

Answer 29

tensilon test - more acetylcholine (inhibiting breakdown and absorption of acetylcholine) in the body

Question 30

what is a tensilon test

Answer 30

acetylcholinesterase inhibitor (ase is an enzyme) cholinesterase inhibitor

Question 31

who is going to get better after tensilon

Answer 31

myasthenia crisis - (cholinergic crisis will get worse)

Question 32

**4 key points

Answer 32

auto-immune neuromuscular junction - no cognitive impairment biggest risk for respiratory problems occular tests know difference between myasthenia and cholinergic crisis