A 56-year-old woman presents to the emergency department complaining of droopy eyelids, blurred vision, difficulty swallowing, and shortness of breath for two days. She has had a cold, but denies recent trauma, headache, fever, neck stiffness, photophobia, cough, hoarseness, or pain.
She has a past medical history of myasthenia gravis, and says she has been compliant with her medications. On examination, she is afebrile, has marked ptosis (the photo was taken when the patient was asked to open her eyes as widely as possible), pooled secretions in the oropharynx, and shallow respirations. Her forced vital capacity is 15 mL/kg and negative inspiratory force 25 cm H2O.
What is the diagnosis, and how would you manage her condition? See p. 12.