Myasthenia Gravis (MG) Quiz
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Questions and Answers

What is believed to be the mechanism by which plasmapheresis treats Myasthenia Gravis?

  • It rids plasma of certain antibodies that contribute to the immune system attack on the nerves (correct)
  • It reduces the production of acetylcholine in the nerve cells
  • It increases the transmission of impulses from nerve to muscle cells
  • It stimulates the growth of new muscle cells

    • What is the primary cause of Myasthenia Gravis?

  • A genetic disorder that affects the transmission of nerve impulses
  • A viral infection that damages the neuromuscular junction
  • An autoimmune disorder that destroys acetylcholine receptor sites (correct)
  • A hormonal imbalance that affects muscle strength

    • What is the significance of electromyography (EMG) in diagnosing Myasthenia Gravis?

  • It visualizes the neuromuscular junction
  • It detects the presence of antibodies in the serum
  • It measures the strength of muscle contractions
  • It shows a rapid decrease in the amplitude of evoked potentials (correct)

    • Which of the following is a characteristic of the neuromuscular transmission in Myasthenia Gravis?

    <p>Decreased transmission of impulses from nerve to muscle cells</p> Signup and view all the answers

    What is the role of acetylcholine receptor sites in Myasthenia Gravis?

    <p>They are destroyed by the antibodies in the autoimmune disorder</p> Signup and view all the answers

    What is the primary site of muscle weakness in Myasthenia Gravis?

    <p>Muscles innervated by the cranial nerves</p> Signup and view all the answers

    What is the purpose of Carbidopa in the treatment of Parkinson's disease?

    <p>To prevent the breakdown of dopamine in the periphery</p> Signup and view all the answers

    What is the primary characteristic of Relapsing-Remitting Multiple Sclerosis (RRMS)?

    <p>Relapses develop over 1-2 weeks and resolve over 4-8 months</p> Signup and view all the answers

    What is the mechanism of action of Anticholinergic medications in the treatment of Parkinson's disease?

    <p>Inhibiting the action of acetylcholine</p> Signup and view all the answers

    What is the primary use of Bromocriptine mesylate in the treatment of Parkinson's disease?

    <p>To stimulate the release of dopamine in the substantia nigra</p> Signup and view all the answers

    What is the prevalence of Relapsing-Remitting Multiple Sclerosis (RRMS) among all cases of Multiple Sclerosis?

    <p>85% of cases</p> Signup and view all the answers

    What is the primary difference between Primary Progressive Multiple Sclerosis (PPMS) and Secondary Progressive Multiple Sclerosis (SPMS)?

    <p>Presence of remission</p> Signup and view all the answers

    What is the purpose of Antiviral medications, such as Amantadine, in the treatment of Parkinson's disease?

    <p>To reduce rigidity, tremor, and bradykinesia</p> Signup and view all the answers

    What is the common side effect of Anticholinergic medications, such as Benztropine mesylate and procyclidine?

    <p>Dry mouth, blurred vision, constipation, and urinary retention</p> Signup and view all the answers

    What is the primary mechanism of action of neostigmine bromide and pyridostigmine bromide?

    <p>Blocking the action of cholinesterase at the neuromuscular junction</p> Signup and view all the answers

    Which of the following is a common side effect of anticholinesterase drugs?

    <p>Fasciculations (muscle twitching)</p> Signup and view all the answers

    What is the primary indication for corticosteroids, such as prednisone, in the management of autoimmune disorders?

    <p>Suppressing the autoimmune response</p> Signup and view all the answers

    Why should anticholinesterase drugs be administered with milk and crackers?

    <p>To decrease gastrointestinal upset</p> Signup and view all the answers

    What is the importance of assessing muscle strength and vital capacity before and after medication?

    <p>To monitor the effectiveness of the medication</p> Signup and view all the answers

    Why is it important to check the gag reflex and swallowing ability before feeding?

    <p>To assess the risk of aspiration</p> Signup and view all the answers

    What is the purpose of providing a mechanical soft diet?

    <p>To promote optimal nutrition</p> Signup and view all the answers

    Why should mealtimes coincide with the peak effects of the medication?

    <p>To promote optimal nutrition</p> Signup and view all the answers

    Study Notes

    Myasthenia Gravis (MG)

    • A neuromuscular disorder characterized by a disturbance in the transmission of impulses from nerve to muscle cells at the neuromuscular junction.
    • Causes extreme muscle weakness, especially in voluntary muscles innervated by cranial nerves.
    • Highest prevalence is between ages 15-35 for women and over 40 for men.
    • Affects women more than men.
    • Thought to be an autoimmune disorder where antibodies destroy acetylcholine receptor sites on the postsynaptic membrane.

    Symptoms of Myasthenia Gravis

    • Weakness of eye muscles, difficulty in swallowing, or slurred speech.
    • Decreased amplitude of evoked potentials in electromyography (EMG).

    Medical Management

    • Anticholinesterase drugs: neostigmine bromide (Prostigmin), pyridostigmine bromide (Mestinon), and edrophonium chloride (Tensilon).
    • Block action of cholinesterase and increase levels of acetylcholine at the neuromuscular junction.
    • Side effects: excessive salivation and sweating, abdominal cramps, nausea and vomiting, diarrhea, and fasciculations (muscle twitching).
    • Corticosteroids: prednisone, used if other drugs are not effective, suppress autoimmune response.

    Nursing Management

    • Administer anticholinesterase drugs as ordered.
    • Give medication exactly on time.
    • Give with milk and crackers to decrease GI upset.
    • Monitor effectiveness of drugs: assess muscle strength and vital capacity before and after medication.
    • Observe for side effects.
    • Promote optimal nutrition.
    • Mealtimes should coincide with the peak effects of the drugs: give medications 30 minutes before meals.
    • Check gag reflex and swallowing ability before feeding.
    • Provide a mechanical soft diet.

    Multiple Sclerosis (MS)

    • A chronic, progressive, and often disabling disease that affects the central nervous system (CNS).

    Types of Multiple Sclerosis

    • Relapsing-remitting MS (RRMS): 85% of cases, relapses develop over 1-2 weeks and resolve over 4-8 months.
    • Progressive-relapsing MS (PRMS): 5% of cases, absence of remission and client's condition does not return to baseline.
    • Primary progressive MS (PPMS): 10% of cases, steady, gradual neurologic deterioration without remission.
    • Secondary progressive MS (SPMS): begins with RRMS course that later becomes steadily progressive.

    Medications for Multiple Sclerosis

    • Carbidopa (Sinemet): prevents breakdown of dopamine in the periphery and causes fewer side effects.
    • Antiviral: Amantadine (Symmetrel), used in early/mild cases to reduce rigidity, tremor, and bradykinesia.
    • Anticholinergic: Benztropine mesylate (Cogentin), procyclidine (Kemadrin), relieve tremor and rigidity.
    • Dopamine agonist: Bromocriptine mesylate (Parlodel), stimulates release of dopamine in the substantia nigra.
    • Tricyclic antidepressants: given to treat depression.
    • Antihistamines: have mild central anticholinergic and sedative effects, and may reduce tremors.

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    Description

    Test your knowledge of Myasthenia Gravis, a neuromuscular disorder causing muscle weakness, its diagnosis, and treatment options.

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