General
What type of disease is MG?
Autoimmune
Early Sx?
Ptosis, diplopia, and fatigue
Fatigable weakness
Pharm Management?
Pyridostigmine (cholinesterase inhibitors) and Neostigmine are mainstay
Prognosis?
Good with treatment!
What type of distribution?
Bimodal
Aggravating and Alleviating?
Activity worsens it AND rest improves it
What serologic testing will you run in patients?
ACH receptors antibodies
Other pharm options?
Immunosuppressive therapy/ steroids
Myo?
Muscle
Pathophysiology?
Autoantibodies attacking either ACH receptors or muscle specific kinase WHICH blocks receptors at the neuromuscular junction AND stops signals from stimulating muscles
What are bulbar sx?
Results from damage to the LMN in Brainstem... CN 9-12
-speech and swallowing
What are other studies you would order?
Ice pack test --> muscular sx improve with cold temperature!
EMG --> showing decremental response
Chest CT/MRI --> eval for tumor burden
What if thymus is the cause?
Take it out (thymectomy)
Asthenos?
Associations?
Thymoma or Thymus Hyperplasia
Examples in voluntary muscles??
*Controlling eye movements, eyelids, and swallowing
What test is used to improve muscle strength by increasing ACH levels?
Edrophonium (Tensilon) test..... this is very niche + not on our slides
also open evidence says its no longer used
Myasthenic Crisis Treatment?
IVIG + Plasmapheresis
Gravis?
heavy
Risk Factors
Younger women <50 + older men >60
Reflexes and Sensation??
Usually NORMAL!
What meds to AVOID in MG?
Fluoroquinolones, macrolides, and aminoglycosides!
Memory trick for progression?
Mind to Ground ---> starts from the eyes and goes down