Myasthenia Gravis

Question 1

Definition

Answer 1

Acquired autoimmune disease characterized by muscle weakness

Question 2

Two types

Answer 2

Ocular

Generalized

Question 3

Worsen with

Answer 3

Exercise and improve with rest

Question 4

Death from

Answer 4

Respiratory failure

Question 5

Fatigue and weakness of

Answer 5

Cranial nerves
Skeletal muscles
Respiratory muscles

Question 6

Caused by

Answer 6

Distorted acetylcholine receptors in the muscle end plate membranes
Nerve impulses do not generate muscle contraction

Question 7

Thymoma

Answer 7

Encapsulated brain tumor

Causes abnormal growth of thymus gland

Question 8

Motor manifestations

Answer 8

Muscle weakness that improves with rest 
Poor posture
Ocular palsied
Ptosis
Diplopia
Respiratory compromise
Bowel and bladder
Fatigue

Question 9

Sensory manifestations

Answer 9

Muscle achiness
Paresthesias
Decreased sense of smell and taste

Question 10

Onset

Answer 10

Insidious

Question 11

Bulbar involvement

Answer 11

Affected
Facial expression
Chewing
Speech

Question 12

The patients face

Answer 12

Snarl instead of smile
Hanging jaw (they might prop it up)

Question 13

Periods of remission

Answer 13

And exacerbation

Question 14

Rapid development may be caused by

Answer 14

Infection
Pregnancy
Anesthesia

Question 15

Difficulty with

Answer 15

Climbing stairs
Lifting heavy objects
Raising arms overhead

Question 16

No

Answer 16

Pain
Smell
Taste

Question 17

Eaton-lambert syndrome

Answer 17

Form of myasthenia often seen with small cell carcinoma of the lung

Question 18

Treatment drugs

Answer 18

Cholinestrase inhibitors
Prednisone
Immunosuppressants

Question 19

Tension test

Answer 19

Inhibits breakdown of ACh

Patients show marked improvement for 4-5 minutes

Question 20

For exacerbation

Answer 20

Plasmapheresis

Question 21

Cholinergic crisis

Answer 21

Too much cholinesterase inhibitor drugs

Increase parasympathetic

Question 22

Myasthenic crisis

Answer 22

Too little cholineserase drugs 
Increase secretions 
Increase pulse
Increase BP
Increase respirations 
Weak, fatigue

Question 23

Tensilon antidote

Answer 23

Atropine sulfate

Question 24

Diagnosis- labs

Answer 24

Thyroid
Other immune disorders?
Positive ACh receptor antibodies
Negative does not rule out

Question 25

Drug of choice

Answer 25

Pyridostigmine | Help improve muscle condition and strength

Question 26

Education for drugs

Answer 26

Give drugs on time Administer with small amount of food (GI effects) Eat meal 45 minutes after Blood levels

Question 27

Dysphagia

Answer 27

No talking | Just eating

Question 28

Eye protection

Answer 28

Tape eyes shut | Lubrication of artificial tears

Question 29

Triggers

Answer 29

``` Infection Stress Exercise Sedatives Enemas ```

Question 30

Avoid

Answer 30

``` Overeating Crowds Overheating Sleeping Emotional ```

Question 31

Surgery

Answer 31

Thymectomy | May show improvement if done within two years of onset