You have 25 year old female patient with the following symptoms: eyelid droop, d

Question

You have 25 year old female patient with the following symptoms: eyelid droop, double vision, and muscle weakness in the arms and legs. The patient has a series of tests that confirm this patient has the disease myasthenia gravis.

Your patient wants to know how they are different from a normal, healthy person. You correctly tell the patient that compared to a normal person, a person with myasthenia gravis has _______________ at the neuromuscular junction. A) larger amplitude (more depolarization) end plate potentials B) more inhibitory end plate potentials (more hyperpolarization at the motor end plate) C) less functioning ACh receptors than normal on skeletal muscle cells D) smaller amplitude (less depolarization) end plate potentials E) C and D  

One test used to help confirm a diagnosis of myasthenia gravis is an “anticholinesterase test” and the drug Tensilon (edrophonium) is most commonly used for this test. In this test, the patient is given Tensilon, a drug that inhibits acetylcholinesterase (it is a short acting acetylcholinesterase inhibitor). Which result would indicate the patient has myasthenia gravis? A) increased muscle weakness during the anticholinesterase (Tensilon) test B) decreased muscle weakness during the anticholinesterase (Tensilon) test

Being a great health care provider you know that during the “anticholinesterase test” a ___________ in heart rate occurs in some patients that you should be prepared for, and therefore, you should have ___________ available in case that occurs. A) increase, atropine B) decrease, acetylcholine C) decrease, beta-1 antagonist D) decrease, atropine E) increase, beta-1 agonist

You write a prescription for the drug neostigmine for this patient you have diagnosed with myasthenia gravis. Could a side effect of neostigmine treatment be over-activity of muscarinic receptors causing increased gut motility, diarrhea, and excess salivation? A) yes, it makes sense B) no, it does not make sense

Explanation / Answer

Blank 1 Answer is C )less functioning acetylcholine receptors than normal on skeletal muscle cell.

Blank 2 answer is B) decreased muscle weakness during anticholinesterase test.

Blank 3 answer is D) decrease (Ach so available may act on M2 receptors and cause bradycardia) and atropine (to block the muscarinic effects).

Blank 4 answer is A) yes,it makes sense

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