NMJ Disorders

Question 1

discuss MG

Answer 1

autoimmune sha where attacks AChRs on postsynaptic

fluctuating weakness - kaya una then di na

women: 20-30
men: 50-60

under 40: F
later in life: M

Question 2

initial sx of MG

Answer 2

CN 3,4,6: weak EOMS, ocular palsies, diplopia, ptosis

lid twitch sign - naiiwan eyelid

trident tougne

Question 3

advance sx of MG

Answer 3

prob in facial muscles, mastication, swallow and speech

erector spinae - most common

tib ants, triceps, face

respi and sphincter msucles if severe

Question 4

diagnosis for MG

Answer 4

EMG

acetylcholinesterase inhibitor test: neostigmine and edrophonium

blood test - antibodies

Question 5

prognosis for MG

Answer 5

highly variable - yung iba stable or remit tas iba rapid

assoc c thymoma

1st yr: respi complications
4-7 yr: second danger

most pt live productive lives

Question 6

clinical grading of MG

Answer 6

class 1: weakness in EOM only

class 2: mild weakness in EOM

class 3: mod weakness in EOM

class 4: severe weakness in EOM

2-4A: EOM and limbs/axial

2-4B: EOM, limbs/axial and oropharynges

Question 7

discuss LEMS

Answer 7

presynaptic - calcium gate prob = no Ach release

symm wekaness of proximal muscles and dry mouth

inverse myesthenia or 2nd wind = lalakas as tumagal

MALES

Question 8

sx of LEMS

Answer 8

initial: diff STS, stiar neg or walking

weak trunk, girdle and LE

bronchogenic carcinoma