Neurology — Flashcards

Flashcard 371: What investigation is used to help confirm the diagnosis of myasthenia gravis? _____

Answer: EMG with repetitive nerve stimulation

Flashcard 372: What is the next step in management for a patient developing respiratory failure due to myasthenic crisis? _____

Answer: Intubation

Flashcard 373: Following intubation, myasthenic crisis may be managed with _____ PLUS IVIG or plasma exchange

Answer: High-dose prednisone

Flashcard 374: Bell's palsy improves after ~_____ & is usually gone within 2 months

Answer: 2.5 weeks

Flashcard 375: _____ is an autoimmune disease due to production of antibodies against post-synaptic nicotinic ACh receptors at motor end plates

Answer: Myasthenia gravis

Flashcard 376: Myasthenia gravis has a bimodal age distribution at _____ and ~60 years old

Answer: ~20

Flashcard 377: Myasthenia gravis can be fatal because of _____

Answer: respiratory compromise

Extra: This life-threatening condition is known as a Myasthenic Crisis, characterized by neuromuscular respiratory failure requiring intubation.

Flashcard 378: Myasthenia gravis has progressive weakness because _____

Answer: high conc. of ACh are needed to compete with anti-ACh antibodies and yield the same muscle strength. Repetitive use means there is not enough time for ACh to be replenished, thus smaller and smaller amounts of ACh are released and the muscle becomes weaker and weaker

Flashcard 379: What is the first-line prophylaxis of tension headache? _____

Answer: Low-dose amitriptyline

Extra: Prophylaxis for Tension-Type Headache (TTH): - 1st line: Amitriptyline (TCA) - 2nd line: Venlafaxine (SNRI) or Mirtazapine - 3rd line: Clomipramine, Maprotiline, or Mianserin

Flashcard 380: What is the self-care management of Bell's palsy? _____

Answer: Eye protection: - artificial tears / lubricants to prevent eyes drying - taping of eyes overnight to keep shut Eating: - Straws & soft diet