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Microbiology Fundamentals 2nd Edition by Jennifer Bunn,Marjorie Kelly Cowan
Edition 2ISBN: 978-1259572760Microbiology Fundamentals 2nd Edition by Jennifer Bunn,Marjorie Kelly Cowan
Edition 2ISBN: 978-1259572760 Exercise 1
CA S E FIL E
Too Much of a Good Thing
I was working in a neurology unit when a young woman named Stacy was admitted. Stacy was 24 years old. She was married and had a 2-year-old at home. She was a full-time student, studying social work at the local university.
Stacy had been referred to one of our neurologists by her family doctor with some unusual symptoms. Over the past several months, Stacy had been experiencing increasing fatigue that she described as akin to "walking under water." She had to walk considerable distances on campus and she was finding it very difficult to climb stairs. She complained of blurred vision and her eyelids sagged. She had lost weight and stated that eating was "too much effort." She ate mainly soft foods that were easy to chew because eating meat and other foods that required a lot of chewing took too much effort. Her facial expression was fixed-even smiling took too much energy. Stacy and her family were very frightened by her symptoms.
She was examined by the neurologist, who immediately suspected myasthenia gravis. He admitted her to the unit and ordered several tests to confirm the diagnosis, including a blood test for acetylcholine receptor antibodies, an electromyography, and nerve conduction studies. A CT of the chest was also ordered. Fifteen percent of patients with myasthenia gravis have a thymoma, or a tumor on the thymus.
The CT showed the presence of a thymoma, and the other tests were all indicative of myasthenia gravis. Stacy was scheduled for a thymectomy. She was also started on prednisone and neostigmine.
Following surgery, Stacy gradually improved, although she stated that fatigue continued to be a problem; however, she noticed an overall improvement in muscle strength. She was able to continue her education on a part-time basis with scheduled rest periods.
• What is the underlying cause of myasthenia gravis?
• How do immunosuppressant drugs improve symptoms in myasthenia gravis?
Too Much of a Good Thing
I was working in a neurology unit when a young woman named Stacy was admitted. Stacy was 24 years old. She was married and had a 2-year-old at home. She was a full-time student, studying social work at the local university.
Stacy had been referred to one of our neurologists by her family doctor with some unusual symptoms. Over the past several months, Stacy had been experiencing increasing fatigue that she described as akin to "walking under water." She had to walk considerable distances on campus and she was finding it very difficult to climb stairs. She complained of blurred vision and her eyelids sagged. She had lost weight and stated that eating was "too much effort." She ate mainly soft foods that were easy to chew because eating meat and other foods that required a lot of chewing took too much effort. Her facial expression was fixed-even smiling took too much energy. Stacy and her family were very frightened by her symptoms.
She was examined by the neurologist, who immediately suspected myasthenia gravis. He admitted her to the unit and ordered several tests to confirm the diagnosis, including a blood test for acetylcholine receptor antibodies, an electromyography, and nerve conduction studies. A CT of the chest was also ordered. Fifteen percent of patients with myasthenia gravis have a thymoma, or a tumor on the thymus.
The CT showed the presence of a thymoma, and the other tests were all indicative of myasthenia gravis. Stacy was scheduled for a thymectomy. She was also started on prednisone and neostigmine.
Following surgery, Stacy gradually improved, although she stated that fatigue continued to be a problem; however, she noticed an overall improvement in muscle strength. She was able to continue her education on a part-time basis with scheduled rest periods.
• What is the underlying cause of myasthenia gravis?
• How do immunosuppressant drugs improve symptoms in myasthenia gravis?
Explanation
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Verified
Myasthenia Gravis (MG) is a chronic neur...
Microbiology Fundamentals 2nd Edition by Jennifer Bunn,Marjorie Kelly Cowan
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