Deck 29: Myasthenia Gravis

Question 1

Myasthenia gravis:
1) interferes with acetylcholine transmission.
2) causes weakness of voluntary muscles.
3) is an ascending paralysis starting in the legs.
4) is usually preceded by a viral infection.

A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3

Answer 1

1, 2

Question 2

Which of the following is/are signs and symptoms associated with myasthenia gravis?
1) Double vision
2) Weakness of neck muscles
3) Drooping of eyelids
4) Difficulty speaking

A)2
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4

Answer 2

1, 2, 3, 4

Question 3

What test is usually performed to confirm the diagnosis of myasthenia gravis?

A) Electromyography
B)Pulmonary function testing
C)Complete blood count
D)Electroencephalogram (EEG)

Answer 3

Electromyography

Question 4

Clinical indications that a patient with myasthenia gravis has acute ventilatory failure include:
1) NIF < -25 cm H₂O
2) VC < 20 ml/kg
3) PaCO₂ > 45 mm Hg
4) pH < 7.35

A)1
B)2, 3
C)1, 4
D)1, 2, 3, 4

Question 5

Because of respiratory failure, your patient with myasthenia gravis was placed on mechanical ventilation and is now stable. What will the chest radiograph most likely show?

A) Normal lungs
B)Mediastinal shift
C)Pericardial tamponade
D)Pneumonia

Question 6

In a myasthenia gravis patient, what happens after a rest period?

A) There is no clinical change.
B)Strength decreases.
C)Muscle strength improves.
D)Ascending paralysis descends.

Question 7

Treatment and care of the myasthenia gravis patient include:
1) pyridostigmine (Mestinon).
2) plasmapheresis.
3) thymectomy.
4) mechanical ventilation.

A)1, 3
B)2, 4
C)1, 2, 4
D)1, 2, 3, 4

Question 8

If a patient with myasthenia gravis is given the drug edrophonium (Tensilon), what will happen?

A) Heart rate will increase.
B)Strength will improve for a short time.
C)There will be a long-term improvement in strength.
D)The patient will weaken for a short time.

Question 9

Your patient with myasthenia gravis is being given a corticosteroid medication. Long-term complications of this medication include all of the following, EXCEPT:

A) infections.
B)cataracts.
C)bronchodilation.
D)osteoporosis.

Question 10

Which demographic group(s) is/are most likely to develop myasthenia gravis?
1) African-American female > 40 years of age
2) White male < 40 years of age
3) Female 15-35 years of age
4) Male 40-70 years of age

A)1
B)4
C)2, 3
D)3, 4

Question 11

The physician is recommending a thymectomy in a patient. The benefit of this procedure is to:

A) remove the source of anti-ACh receptor antibodies.
B)block the antigen-antibody reactions.
C)remove the source of cholinesterase.
D)prevent the development of myasthenia gravis.

Question 12

The major pathologic or structural changes of the lungs associated with ventilatory failure accompanying myasthenia gravis include:
1) bronchospasm.
2) airway obstruction.
3) mucus accumulation.
4) alveolar dilation.

A)1, 4
B)2, 3
C)1, 2, 3
D)1, 2, 3, 4

Question 13

Your patient has a severe case of myasthenia gravis. It is most important that she be monitored for:

A) urine output.
B)atrial fibrillation.
C)hypotension.
D)apnea.

Question 14

A 50-kg (110-lb) 30-year-old female patient has myasthenia gravis. Bedside spirometry has found her VC to be 700 ml and NIF -14 cm H₂O. Vital signs show a respiratory rate of 38, heart rate of 140/minute, and blood pressure of 130/90 mm Hg. What would you recommend be done?

A) Check the vital signs every hour.
B)Begin intermittent positive pressure breathing (IPPB) treatments.
C)Administer supplemental oxygen.
D)Begin mechanical ventilation.

Question 15

A patient with myasthenia gravis will have lung volume and capacity findings that show:

A) an upper airway obstruction.
B)an obstructive pulmonary disorder.
C)a restrictive pulmonary disorder.
D)ascending leg muscle weakness.