NM Myasthenia Gravis

Question 1

_______ ______ disorder characterized by progressive muscular weakness and ______ ____ _________

Answer 1

Neuromuscular junction

Fatigue on exertion

Question 2

Etiology is ________ ________ ________ ______ on ____ receptors at the NM junction

Answer 2

Autoimmune antibody mediated attack

ACh

Question 3

Muscle strength becomes worse with continuing _______ and is improved with _____

Answer 3

Contraction

Rest

Question 4

What are the 4 types listed?

Answer 4

Ocular myasthenia
Mild generalized myasthenia
Severe generalized myasthenia
Myasthenia crisis

Question 5

What is ocular myasthenia?

Answer 5

Only involves the extraocular muscles

Question 6

What is mild and severe generalized mysathenia?

Answer 6

Involves bulbar - the extraocular, facial, and mastication muscles) and proximal limb girdle muscles

Question 7

What is myasthenic crisis?

Answer 7

With respiratory failure — must call 911

Question 8

May progress to mild to severe in how many months?

Answer 8

18 months

Question 9

Exam:

CN nerves: what are you looking for?

Answer 9

Diplopia, ptosis
Progressive dysarthria
Nasal speech
Difficulties in chewing/swallowing
Difficulty with facial expression
DROOPING FACIAL MUSCLES

Question 10

Respiratory function: breathing difficulties and ______ voice

Answer 10

Hoarse

Question 11

Muscle strength: ______ more involved

Answer 11

Proximal

And there is FATIGUE

Question 12

What meds can be used?

Answer 12

Acetylcholinesterase inhibitors - pyridostigmine
Corticosteroids - prednisone, methylprednisolone
Immunosuppressants - azathioprine, IVG
Alternative Tx - plasmapheresis, thymectomy

Question 13

PT GOALS: Focus on energy conservation, and ____

Answer 13

REST