A 42-year-old woman comes to the physician because of a month history of diffuse weakness. There is no cervical or axillary lymphadenopathy. Cardiopulmonary and abdominal examination shows no abnormalities. A lateral x-ray of the chest shows an anterior mediastinal mass. A surgical remova; of anterior mass is planned. Preoperative nerve conduction studies revealed a decremental response to repetitive motor nerve stimulation. She has no other medical conditions and does not use tobacco, alcohol, or illicit drugs. The patient has no drug allergies. Compared to a healthy individual, which of the following anesthesia-related medications is most likely to have increased potency in this patient?

Question

A 42-year-old woman comes to the physician because of a month history of diffuse weakness. There is no cervical or axillary lymphadenopathy. Cardiopulmonary and abdominal examination shows no abnormalities. A lateral x-ray of the chest shows an anterior mediastinal mass. A surgical remova; of anterior mass is planned.   Preoperative nerve conduction studies revealed a decremental response to repetitive motor nerve stimulation.  She has no other medical conditions and does not use tobacco, alcohol, or illicit drugs.  The patient has no drug allergies.  Compared to a healthy individual, which of the following anesthesia-related medications is most likely to have increased potency in this patient?

Quizplus · Accepted Answer

Eductional Objective: Myasthenia gravis (MG) is caused by autoantibodies against postsynaptic nicotinic acetylcholine receptors, leading to fewer functional receptors and fatigable muscle weakness. Nondepolarizing neuromuscular blocking agents (eg, vecuronium) are competitive antagonists of nicotinic receptors; due to the depletion of receptors, patients with MG are extremely sensitive to these agents.

A 42-Year-Old Woman Comes to the Physician Because of a Month