Clinical Presentation
Drooping of eyelid
What is ptosis?
These prevent Ach from binding to their receptors in MG
What are antibodies?
Confirmatory test that detects the presence of anti-Ach receptor antibodies.
What is Serology testing?
The 4 main treatment strategies.
What are cholinesterase inhibitors, immunosuppressive regiments, immunomodulators, and thymectomy.
Important lifestyle habits to maintain.
What is regular exercise, eating healthy (Mediterranean diet :)), social interactions, hobbies?
Nerve fiber that should NOT be affected
What is sensory nerve?
In 5-8% of MG pts, these type of antibodies are found instead of the Ach receptor antibodies.
What are muscle specific receptor tyrosine kinase antibodies?
Scan and location of test that can be done to rule out ddx.
What is MRI/CT brain?
Drug class and MOA of Pyridostigmine.
What is an acetylcholinesterase inhibitor? What is binding to acetylcholinesterase to prevent degradation of Ach in synaptic cleft?
Stress management techniques.
What is gentle exercise (yoga, tai chi), meditation, cognitive behavioral therapy, psychotherapy, journaling, financial support, social workers?
Muscles in this nervous system are affected
What is the somatic nervous system?
The end result of antibodies binding to the receptor. (Think what happens to the muscle)
What is muscle cell destruction?
diagnostic function test where decrement of greater than 10% in cumulative compound muscle action potential is detected in MG.
What is repetitive nerve stimulation?
Contraindications and adverse effects of Pyridostigmine.
What are..
CI - MuSK positive, cholinergic crisis, asthma, COPD, and cardiac dysrhythmias.
AE - abdominal cramping and diarrhea, increased salivation and bronchial secretions, fasciculations.
Use of going to physical therapist.
What is regaining ambulation and limb strength after crisis?
Impairment of eye movements, the response to light, or both
What is CN III palsy?
Pathway that is part of the immune system that is activated by Ach receptor antibodies.
What is the classical complement pathway?
test for improvement of myasthenic weakness with muscle cooling.
What is ocular cooling test?
1st line choice for immunosuppressive drug.
What is prednisone?
Prognosis of patients with MG.
What is improvement occurring early but are rarely permanent?
Pt is unable to keep their eyes shut or sclera begins to show
What is positive peek sign?
Autoantibodies produced due to immune response from underlying cancer.
**bonus 50 pts if specific cancers can be named**
Paraneoplastic syndrome. Bronchogenic carcinoma, thymic neoplasm.
Diagnostic with ptosis where improvement in strength of affected muscle is required for a positive result after injecting the compound.
What is the Edrophonium test?
Purpose of thymectomy.
What is surgical removal of thymus because they produce helper T cells which help produce B cells?
Doctor specialist patients typically need follow up evals from.
What is a neurologist?