[Myaesthenia Gravis] Flashcards Preview

NEUROLOGY > [Myaesthenia Gravis] > Flashcards

Flashcards in [Myaesthenia Gravis] Deck (33)
1

[MG]: What might be noticed on smiling

Myaesthenic snarl
(preserved vertical but decreased horizontal excursion of lips)

2

[MG]: how might you elicit the increasing muscular fatigue

voice fades on counting to 50

3

[MG]: how are tendon reflexes affected

Tendon reflexes normal

4

[MG]: Under the age of 50 MG is associated with (2)

Females
Thymic hyperplasia

5

[MG]: Over the age of 50 MG is associated with (2)

Males
thymic atrophy/tumours

6

[MG]: Antibodies are directed against ...

nicotinic acetylcholine receptors

7

[MG]: Which symptoms are usually first noticed

ocular muscle fatigue
difficulty swallowing/speaking

8

[MG]: What is the peek sign indicative of

Shows orbicularis fatigue

9

[MG]: What antibodies are present in 90%

Anti-AchR

10

[MG]: if Mg is confined to the eyes anti-AchR is only ...%

70

11

[MG]: If seronegative for AchR which antibodies do you check for

MuSK (muscle specific tyrosine kinase)

12

[MG]: In a MG +ve pt what would repetitive nerve stimulation show

Decremental muscle response

13

[MG]: Ice application to the shut affected ptotic eye for 2 mins may improve ptosis by ... mm

>2mm

14

[MG]: What imaging would you request

CT of thymus

15

[MG]: Symptomatic Tx is ...

Pyridostigmine (anticholinesterase)

16

[MG]: 1st line Tx for relapses is ...

Prednisolone
+ azathioprine/d
OR
Methotrexate /week

17

[MG]: How often should the patient receive immunosuppressive drugs

alternate days

18

[MG]: What should be co-prescribed with the 1st line drug

Osteoporotic prophylaxis

19

[MG]: ... once a week can be prescribed along side steroids tx

methotrexate

20

[MG]: ... daily can be prescribed along side steroids tx

azothioprine

21

[MG]: If anticholinesterases do not control symptoms and the pt is <50, what Tx option is there

Thymectomy

22

[MG]: What is the major worry

respiratory muscle fatigue during relapse

23

[MG]: how can you monitor for the main worry in MG patients

Forced vital capacity

24

[MG]: if starting azathioprine what should be checked weekly fror 8 weeks then 12-weekly (2)

FBC
LFT

25

[MG]: involvement of muscel groups starts at ... and ends with .. muscle involvement

ocular
(bulbar, face, neck, limb)
Truck

26

[MG]: pyridostigmine SEs i.e. cholinergic (3)

salivation
lacrimation
miosis

27

[MG]: 5 days pre-op to thymectomy what may be give

IV Immunoglobulin

28

[MG]: Myasthenic crisis is the major medical concern. What is it.

life threatening weakness of respiratory muscles in relapse

29

[MG]: What is the FVC for ventilatory support

<20mL/Kg

30

[MG]: Tx for myasthenic crisis (2)

plasmapheresis
or
IV Ig

31

[lambert-eaton}: what is the difference in presentation between MG and LE myasthenic syndrome?

gait difficulty before eye signs

32

[lambert-eaton}: what is the pathophysiological cause of LES?

Antibodys against pre-synaptic membrane Calcium voltage channels

33

[lambert-eaton}:LES can be autoimmune or caused by ...

small cell lung cancer (paraneoplastic)