myasthenia gravis

Question 1

myasthenia gravis is low in?

Answer 1

acetylcholine or ACH

Question 2

a neuromuscular disorder characterized by failure of transmission of nerve impulses at the myoneural junction

Answer 2

myasthenia gravis

Question 3

MG is what type of disorder

Answer 3

autoimmune disorder

Question 4

there is a decreased number of what?

Answer 4

functioning acetylcholine receptor sites

Question 5

age for young women in MG

Answer 5

20-30

Question 6

age in older men for MG

Answer 6

60-70

Question 7

start of symptoms

Answer 7

Mind to Ground
Descending weakness

Question 8

Patho

Answer 8

cytotoxin - production of b-cells - blocks the nicotinic receptor

Question 9

clinical manifestations

Answer 9

muscle weakness associated with activity - relieved by rest
early morning, full of energy ang ptx with MG but in tye evening, may weakness na
fatigue
impaired speech
ptosis (di magalaw ang eyelids)
diplopia (double vision)
strabismus (duling)
snarl-mask like facial expression
dysphagia (diff in swallowing)
drooling
descending weakness

Question 10

triangular-shaped muscle located in each upper eyelid. The primary function is elevation and retraction of the upper eyelid

Answer 10

levator palpebrae superioris

Question 11

diagnostic test

Answer 11

tensilon test (edrophonium test) - temporarily increases muscle strength
administer through iv 2 mg muna bago 8 mg

Question 12

results in tensilon test

Answer 12

if positive, patient shows surge of energy and muscle strength but returns after 3-5 minutes

if negative - no changes and has muscle weakness (cholinergic crisis, to rule out MG)

Question 13

means to destroy

Answer 13

anticholinesterase

Question 14

first priority

Answer 14

safety in airway
(asssess gag reflex: muscle weakness - cannot swallow properly - aspiration)

Question 15

positive result in tensilon test

Answer 15

ptx shows surge of energy and muscle strength but returns after 3-5 minutes

Question 16

negative tensilon test

Answer 16

muscle weakness
no changes in energy

Question 17

what drug is taken during tensilon test

Answer 17

edrophonium

Question 18

nursing mgmt

Answer 18

assess airway -ability to chew and swallow, cold water to contract muscles in tongue, possible blockage: asthma, foreign object
assess breathing
promote rest through cluster activity (isang bagsakan para mabilis mapagod si ptx)
prevent client from falls
avoid exposure to infections
start meal with cold beverage to contract muscle of the throat
administer medication on time to prevent constipation
administer meds 20-30 mins before meals

Question 19

pharmacological mgmt

Answer 19

acetylchonlinesterase inhibitor/anticholinesterase
- neostigmine (prostigmin) MESTONIN
- ambenomium

Question 20

drug mechanism of action

Answer 20

prevents breakdown of ACH ths helps in neuromuscular impulse

Question 21

caused by undermedication

Answer 21

myasthenia crisis

Question 22

myasthenia crisis manifestation

Answer 22

elevated HR and BP
severe respiratory distress
cyanosis
absent swallow reflex
bowel and bladder incontinence
severe weakness

Question 23

management for myasthenia crisis

Answer 23

increase the dose of edrophonium or mestinon and ready for mech vent

Question 24

caused by overmedication

Answer 24

cholinergic crisis

Question 25

manifestations of cholinergic crisis

Answer 25

diarrhea
polyuria
blurred vision
increased salivation
dysphagia
blurred vision
increased salivation
severe weakness

Question 26

management for cholinergic crisis

Answer 26

provide mech vent
discontinue drug until it decreases
provide 1mg of atropine sulfate

Question 27

normal value of ach and dopamine

Answer 27

high ACH,high dopamine

Question 28

for antiinflammatory effects and to suppress production of antibodies

Answer 28

glucocorticoids/corticosteroids

Question 29

to prevent gastrointestinal upset due to glucocorticoids

Answer 29

antacids

Question 30

removal of the thymus gland that possibly causes the autoimmune response since 25% of patients with MG was found with thymons
surgical intervention for MG

Answer 30

Thymectomy

Question 31

antidote for acetylcholine

Answer 31

atropine sulfate