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Myasthenia gravis: Helping patients have better outcomes

doi: 10.1097/01.NPR.0000419290.91466.6e
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INSTRUCTIONS Myasthenia gravis: Helping patients have better outcomes


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Myasthenia gravis: Helping patients have better outcomes

General Purpose: To provide the nurse practitioner with a review of (MG) and its management. Learning Objectives: After reading this article and taking the test, the NP will be able to: 1. Describe the pathophysiology, epidemiology, and signs and symptoms of MG. 2. Discuss the diagnosis, treatment and potential complications of MG.

  1. MG is classified as which type of disease?
    1. acute
    2. infectious
    3. autoimmune
    4. congenital
  2. Patients with MG commonly have
    1. thymomas.
    2. lymphomas.
    3. sarcomas.
    4. melanomas.
  3. MG frequently affects
    1. men younger than 40 years.
    2. women younger than 40 years.
    3. Hispanics.
    4. Blacks.
  4. Which of the following medications may exacerbate MG symptoms?
    1. immunoglobulin
    2. ciprofloxacin
    3. c acetaminophen
    4. neostigmine
  5. Which is least likely to be the first noticeable symptom of MG?
    1. eye muscle weakness
    2. slurred speech
    3. difficulty swallowing
    4. weak hand grip
  6. Which organization has developed a classification scale for MG?
    1. Myasthenia Gravis Society of North America
    2. Myasthenia Gravis Association
    3. Myasthenia Gravis Foundation of America
    4. International Myasthenia Gravis Association
  7. Paralysis of which muscles occur in myasthenic crisis?
    1. facial
    2. lower limb
    3. respiratory
    4. abdominal
  8. The initial diagnosis of MG involves assessing impairment of
    1. eye movement.
    2. facial movements.
    3. chewing.
    4. gait.
  9. Which diagnostic test is monitored at intervals in the patient with MG?
    1. ECG
    2. myoglobin
    3. forced vital capacity
    4. liver function test
  10. The diagnosis of MG may be immediately confirmed by a patient's response to
    1. atropine.
    2. cholinergic drugs.
    3. naloxone.
    4. beta-agonist bronchodilators.
  11. In response to I.edrophonium chloride, most patients with MG have a marked improvement in muscle tone within
    1. 4 minutes.
    2. 5 to 10 minutes.
    3. 15 to 25 minutes.
    4. 30 to 60 minutes.
  12. Instruct patients prescribed pyridostigmine to take it
    1. 30 minutes before meals.
    2. 30 minutes after meals.
    3. early in the morning.
    4. at bedtime.
  13. Myasthenic crisis is a result of
    1. dehydration.
    2. vitamin deficiency.
    3. undermedication.
    4. overmedication.
  14. For patients with MG who have thymomas, which is often recommended?
    1. radiation therapy
    2. chemotherapy
    3. surgery
    4. periodic monitoring
  15. In patients refractory to conventional therapy, an effective short-term treatment for acute exacerbations of MG is
    1. corticosteroid therapy.
    2. plasmapheresis.
    3. immunosuppressant therapy.
    4. IVIg.
  16. IVIg improves symptoms in about what percentage of patients with MG?
    1. 50%
    2. 60%
    3. 70%
    4. 80%
  17. When first diagnosed with MG, patients often develop
    1. anxiety.
    2. depression.
    3. hand tremors.
    4. weight gain.
  18. Patients with MG are at increased risk for developing
    1. heart failure.
    2. coronary artery disease.
    3. Type II diabetes.
    4. community-acquired pneumonia.


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