Myasthenia Gravis

Question 1

features of myasthenia gravis?

Answer 1

fatiguable muscle weakness

• ptosis
• extraoccular muscles = diplopia
• proximal muscle weakness
• bulbar features = nasal speech, dysarthria, dysphagia

Question 2

associations with myasthenia gravis ?

Answer 2

thymoma
thyme hyperplasia
autoimmune conditions i.e. SLE, pernicious anaemia, thyroid, RA

Question 3

investigations you would carry out for diagnosis of myasthenia gravis ?

Answer 3

single fibre electromyography (SF EMG)

antibodies

• anti-acetylcholine receptor antibody
• anti-muscle specific tyrosine kinase antibody

Question 4

1st line treatment of myasthenia gravis ?

Answer 4

long acting acetylcholinesterase inhibitors e.g. Pyridostigmine

Question 5

management of myasthenia crisis ?

Answer 5

plasmapheresis

IV immunoglobulin