Enable Editing ill a 25-year-old gymnastics instructor presents with complaints
ID: 254048 • Letter: E
Question
Enable Editing ill a 25-year-old gymnastics instructor presents with complaints of muscle weakness in her face that comes and goes. Her symptoms have been getting progressively worse over the past couple of months. She complains her jaw gets tired as she chews and swallowing is more difficult. She also notes some double vision occurs late in the evening, especially after reading for a bit. At work, it has become more difficult to assist her young gymnasts because of upper arm weakness. On physical examination, she has notable ptosis (drooping) of both eyelids after repeated blinking exercises. Electromyography reveals progressive weakness and decreased amplitude of contraction of the distal arm muscles upon repeated mild shocks of the ulnar and median nerves. Both her symptoms and electromyography findings reversed within 40 seconds of intravenous administration of an acetylcholinesterase inhibitor. Blood tests reveal high levels of an anti- acetylcholine receptor antibody in her plasma Jill's treatment includes a long-lasting anticholinesterase drug (acetylcholinesterase inhibitor) and prednisone, a corticosteroid. She likely will also undergo occasional plasmapheresis when her symptoms become especially severe Answer each question in complete sentences 1. How are the antibodies to the acetylcholine receptors interfering with Jil's skeletal muscle function? 2. W improve Jill's skeletal muscle function? hat is acetylcholinesterase and how does an acetylcholinesterase inhibitor act to 3 What is the reason for plasmapheresis? What will i accomplish? 4. What condition might Jill be suffering from? ExplainExplanation / Answer
4 and 1.Jill might be suffering from an autoimmune disorder-Myasthenia gravis in which patient's immune system starts producing antibodies against acetylcholine receptors present on muscles.
These antibodies bind with acetylcholine receptors and block their functions so muscles become unable to take the messages from brain.
2.Acetylcholinestrase is an enzyme present at synapse which cause the degradation of acetylcholine.
Acetylcholinestrase inhibitors work against acetylcholinesterase and stop the breakdown of acetylcholine.These inhibitors increase the amount of acetylcholine availabe to muscles and help muscle activation and contraction.
3. In Plasmapheresis, AchR antibodies are removed and their accumulation is inhibited by immunosuppresent drugs.
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