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31 Cards in this Set
- Front
- Back
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how is myasthenia gravis best defined
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fatiguing weakness, prefers muscles innerv by CNs and less so SN innerv
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what organ is involved in myathenia
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thymus tumor or thymic hyperplasia
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what is the pathology of myasthenia
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immunological deposits on post synaptic membrane esp ACH receptors and DESTROYS then rather than just blocking them
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what dz is this: prob swallowing, diplopia,ptosis, EOM affected, decrease power of speech,weakness over weeks or months,chewing prob, good reflexes
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myasthenia gravis- no changes in reflexes, cerebllar involve, or ans
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who gets myasthenia
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young women or older men
more common in pt w autoimmune dz |
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if myasthenia pt only have ocular symptoms after two years, what is the likely prognosis
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no likely to spread
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what is myasthenic crisis
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inability to swallow even their own secretions, resp impairment, aspiration pneumonia, may require ventilation or intubation
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what makes and easy myasthenia dx
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b/l ptosis generally worse in one eye, with multiple extra-ocular palsies, or weakness of voice, swallowing or facial expression
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when are myasthenia pt strongest and weakest
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strongest in morning and weak as day goes on
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what do nerve conduction studies of myasthenia show
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decremental response to repetitive stim
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what are the antibodies involved in myasthenia
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anti striated muscle-in thymoma pt
anti MuSK- in pt who do not have any skel musc antibodies- tyrosine kinase abs |
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if there is only ocular involvement of myasthenia what test should you do
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MRI of brain to rule out other tumore
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what other drug is given with the tensilon (edrophium test)
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atropine to reduce bradycardia
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what drugs are used treat myasthenia
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start wiht pyridostigmine-aka mesinon ( a cholinesterase inhibitor)..start with 2 times per day and go up to four -there is a long acting form of mestinon to be given bf bed, also give CS ie prednisone
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how else can you treat myasthenia
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plasmapharesis, iv igg
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what drugs can worsen myasthenia
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antibiotics, anesthetics, anticonvulsants
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what is a disease of UMN and LMN and pt has increasing asymmetical weakness
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ALS
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what muscles does ALS have a predilection for
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hands, forearms, larynx, pharynx, muscles of facial expression, LE and Resp musc
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what muscles does ALS spare
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EOM
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what is the main presenting symptom of ALS
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dysarthria
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where are lower motor neurons located
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ant horn of SC to skel muslces
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what are the four kinds of ALS
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1. bulbar, 2. UMN 3. LMN 4. UMN and LMN which is most commnon
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what is the prognosis of ALS
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death within 5 years esp if bulbar symptoms are prom
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what dz is this: worsening weakness, fasciculations in tongue and limbs, atrophy of mus, atrophy and fasic of tongue, split hand more lateral prob, no EOM or bladder or bowel
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ALS
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how is ALS dx confirmed
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UMN and LMN involvment in at least three levels
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what are the cognitive effects of ALS
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apathetic, depressed, modd changes ( pseudobulbar effect. limit in speech content and production
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what mutations are involved in ALS
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SOD1 OR TD-43
cell death of ant horn cells and CS tracts |
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what should ALS emg shoq
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denervation of at least three limbs if evidence of LMN
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what test should u do for dx of ALS
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MRI of brain and cervical SC
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what is the only FDA approved drug for ALS
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Riluzole- prolongs life by three months
can cause hepatic damage |
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what needs to happen when pt is diagnosed with ALS
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plans for death and end of life care
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