Myasthenia gravis

Question 1

Autoimmune antibody against Acetylcholine receptor which result in impaired neuromuscular transmission

Answer 1

Myasthenia gravis

Question 2

Signs and symptoms

Answer 2

Diplopia, ptosis (but pupil is normal), dysphagia, SOB, normal sensation and deep
tendon reflex
fatigability at the end of the day

Question 3

3 tests you have to do for MG

Answer 3

EMG,
TSH (autoimmune thyroid disorders),
CT chest (to detect thymoma)

Question 4

Management of MS

Answer 4

Pyridostigmine

Question 5

Myasthenic crisis and refractory disease is treated by

Answer 5

Plasmapheresis or IVIG

Question 6

Medication may trigger myasthenic crisis:-

Answer 6

quinolone, aminoglycoside, beta blocker, Mg, CCB

Question 7

Lambert-eaton syndrome

Answer 7

mimic MG but weakness improved with activity + diminished tendon reflex
Diagnosed by Anti-voltage calcium channel antibody, always search for hidden malignancy (SCLC)

Question 8

Pediatric patient with ptosis, diplopia with no fasciculation, symptoms worse
through the day and improve next morning, what is the pathophysiology of the
disease?

Answer 8

Anti-bodies against Acetyl choline receptors

Question 9

24-year-old patient present with bilateral ptosis, proximal lower and upper
limbs weakness, Simpson test was positive and after doing edrophonium test
there was rapid improvement of the ptosis, what is the most appropriate
management?

Answer 9

Pyridostigmine

Question 10

Patient known case of myasthenia gravis came to ER with myasthenic crisis,
he is on pyridostigmine, what to do for him in ER?

Answer 10

Plasmapheresis