Mysathenia Gravis

Question 1

Mys

Answer 1

Muscle

Question 2

Asthenia

Answer 2

Weakness

Question 3

Gravis

Answer 3

Serious

Question 4

What is Mysathenia Gravis?

Answer 4

Autoimmune disease which results from antibodies that block or destroy nicotinic acetylcholine receptors at the junction between the nerve and muscle.

Question 5

Is MG a Pre-synaptic or Post-synaptic disorder?

Answer 5

Post-synaptic disorder

Question 6

MG is prevalent in what gender?

Answer 6

Females>Males

Question 7

Tumor in the thymus

Answer 7

Thymoma

Question 8

Manifestations for MG

Answer 8

1. Weakness and rapid fatigue of any of the muscles under voluntary control.
2. Eyes, Face, and Muscles for swallowing
3. PTOSIS (CN3) (Ophthalmoplegia)- Drooping of one or both eyelids
4. Proximal> Distal Weakness (Mostly affects cervical extensors)
5. Decrementing
   Response to Exercise
6. Heat Sensitivity

Question 9

Drooping of one or both eyelids

Answer 9

PTOSIS- CN3 affectation

Question 10

Which may be horizontal or vertical, and improves or
resolves when one eye is closed

Answer 10

Diplopia

Question 11

sustained tight closure of the eyelids can induce fatigue of the orbicularis oculi muscles resulting in the white sclera of the eye slowly becoming apparent under the partially open eye.

Answer 11

Peek Sign

Question 12

Factors that Can Worsen Myasthenia Gravis

Answer 12

1. Fatigue
2. Illness
3. Stress
4. Extreme Heat
5. Medications- beta blockers, calcium channel blockers, quinine, and some antibiotics

Question 13

What do you call about the classification for Myasthenia?

Answer 13

Myasthenia Gravis Foundation of America Clinical Classification Scale

Question 14

Any ocular weakness

Answer 14

Class 1

Question 15

Mild Weakness. May also have ocular muscle weakness of any severity.

Answer 15

Class 2

Question 16

Mild Weakness. Predominantly affecting limb, axial muscles, or both. May also have lesser involvement of oropharyngeal, respiratory muscles or both.

Answer 16

Class 2A

Question 17

Mild Weakness. Predominantly affecting oropharyngeal, respiratory muscles, or both. May also have lesser of equal involvement of limb, axial muscles or both.

Answer 17

Class 2B

Question 18

Moderate weakness affecting other than ocular muscles. May also have ocular muscle weakness of any severity.

Answer 18

Class 3

Question 19

Severe Weakness affecting other than ocular muscles. May also have ocular muscle weakness of any severity.

Answer 19

Class 4

Question 20

Moderate Weakness. Predominantly affecting limb, axial muscles, or both. May also have lesser involvement of oropharyngeal, respiratory muscles or both.

Answer 20

Class 3A

Question 21

Moderate Weakness. Predominantly affecting oropharyngeal, respiratory muscles, or both. May also have lesser of equal involvement of limb, axial muscles or both.

Answer 21

Class 3B

Question 22

Severe Weakness. Predominantly affecting limb, axial muscles, or both. May also have lesser involvement of oropharyngeal, respiratory muscles or both.

Answer 22

Class 4 A

Question 23

Severe Weakness. Predominantly affecting oropharyngeal, respiratory muscles, or both. May also have lesser of equal involvement of limb, axial muscles or both.

Answer 23

Class 4B

Question 24

Defined by intubation, with or without mechanical ventilation, except when employed during routine post op management.

Answer 24

Class 5

Question 25

It is performed by keeping icepacks over eyes for 2-5 minutes & looking at improvement in Ptosis.

Answer 25

Ice Pack Test

Question 26

Diagnostic Evaluation for MG

Answer 26

1. Ice Test or Ice Pack Test 2. Single Fiber EMG 3. Imaging Scans 4. Pulmonary Function Testing 5. Edrophonium Test/ Tensilon Test

Question 27

Medical Management for MG

Answer 27

1. Anticholinesterase Medications (mestinon or pyridostigmine) 2. Immunosuppressive drugs (prednisone, azathioprine, mycophenolate mofetil, tacrolimus, and rituximab)

Question 28

Surgical Management for MG

Answer 28

Thymectomy

Question 29

Assessments

Answer 29

1. Ineffective airway clearance 2. Impaired verbal communication 3. Impaired Physical Mobility 4. Activity Intolerance

Question 30

PT Management for MG

Answer 30

1. Aerobic Exercise 2. Respiratory Muscle Training 3. Strength Training 4. Progressive Resistance Exercises