Myasthenia Gravis Flashcards
myasthenia gravis is what type of disorder
autoimmune disorder - body produces antibodies that attacking itself
dx for myasthenia gravis
blood test to test for antibodies
what is a neuromuscular junction
area of communication between brain and muscle to cause muscle contraction (movement)
what is acetylcholine
a neurotransmitter
what is acetylcholine responsible for
muscle contraction (movement) and helps with cognition/memory
myasthenia gravis only effects the
neuromuscular junction -
in myasthenia gravis there is a deficit in
a deficit in acetylcholine binding to the muscle fiber
does someone with myasthenia gravis have any cognition problems
no - because its only at the neuromuscular junction
s/s of myasthenia gravis
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
in myasthenia gravis you have periods of remissions and exacerbation’s, t or f
true
your chances of getting myasthenia gravis increases with age, t or f
false - earlier onset (teens, twenties)
best way to dx myasthenia gravis - antibody involved
anti-acetylcholine antibody
what other body part is involved in myasthenia gravis
thymus
what is the thymus responsible for
help produce antibodies
what is noted on thymus in myasthenia gravis
benign nodules on their thymus - identifiable by ultrasound
what can keep people in a prolonged state of remission with myasthenia gravis
removal of the thymus
**how do we test for weakness of the face in myasthenia gravis
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
myasthenia gravis r/t acetylcholine production
no deficit in acetylcholine production - deficit is in receptor sites to bind it to the neuromuscular junction
trt for myasthenia gravis
give meds to increase acetylcholine
what do we worry about with myasthenia gravis
airway protection, risk for aspiration, swallowing/chewing
is myasthenia gravis a progressive disease
no - stays the same - treatable - can succumb to secondary issues
is myasthenia gravis life threatening
no
when symptoms are very bad what is the term
myasthenia crisis
s/s of myasthenia crisis
risk for airway issues, choking hazard, severe muscle weakness
what causes a myasthenia crisis
insult, trauma or stress on the body (cold, surgery, pregnancy)
what is a cholinergic crisis
excess of acetylcholine and the neuromuscular junction site
what can cause a cholinergic crisis
over-medication
s/s of cholinergic crisis
respiratory failure
how would we know if pt in ER is having a myasthenia vs cholinergic crisis
tensilon test - more acetylcholine (inhibiting breakdown and absorption of acetylcholine) in the body
what is a tensilon test
acetylcholinesterase inhibitor (ase is an enzyme) cholinesterase inhibitor
who is going to get better after tensilon
myasthenia crisis - (cholinergic crisis will get worse)
**4 key points
auto-immune
neuromuscular junction - no cognitive impairment
biggest risk for respiratory problems
occular tests
know difference between myasthenia and cholinergic crisis
