Myasthenia Gravis: NCLEX Priorities
MG: ptosis, diplopia, fatigability, pyridostigmine, myasthenic vs cholinergic crisis.
Myasthenia is autoimmune, blocking acetylcholine receptors. NCLEX tests fatigability pattern and distinguishing crises.
Recognition
Fatigability, weakness worsens with use, improves with rest. Ptosis, diplopia, dysphagia, generalized weakness. Often worse end of day.
Treatment
Pyridostigmine (Mestinon), acetylcholinesterase inhibitor. Immunosuppressants (steroids, azathioprine). Thymectomy. IVIG/plasmapheresis for crisis.
Myasthenic crisis
Severe weakness, respiratory failure. Edrophonium (Tensilon) test improves weakness. Treat with more pyridostigmine + IVIG/plasmapheresis.
Cholinergic crisis
Too much pyridostigmine. SLUDGE (Salivation, Lacrimation, Urination, Diarrhea, GI cramps, Emesis). Atropine antidote. Tensilon worsens.
Frequently asked
Tensilon test, what does it tell?
Improves myasthenic crisis weakness. Worsens cholinergic crisis. Helps distinguish.
Why thymectomy?
Thymoma often present. Removal can reduce antibody production.
Quick check
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