Myasthenia Quiz: Crisis Or Cholinergic?

1. Which clinical sign is most characteristic of myasthenia gravis?

Muscle weakness that worsens with activity and improves with rest

Constant tremor at rest

Muscle rigidity with lead-pipe quality

Fasciculations visible under the skin

2. Which diagnostic test showing antibodies against acetylcholine receptors confirms myasthenia gravis?

Serum acetylcholine receptor (AChR) antibody test

Complete blood count

Thyroid function tests

Nerve conduction studies only

3. True or False: Ice-pack test (applying ice to the eyes) can temporarily improve myasthenia gravis symptoms.

True

False

4. A patient with myasthenia gravis complains of difficulty chewing and swallowing. What nursing intervention is most appropriate?

Offer soft foods and ensure medications are taken before meals

Restrict fluid intake to prevent aspiration

Encourage rapid eating to conserve energy

Recommend cold beverages only

5. Which neurotransmitter is deficient at the neuromuscular junction in myasthenia gravis?

Acetylcholine (functional deficiency due to receptor blockade)

Dopamine

Serotonin

GABA

6. True or False: Myasthenia gravis is more common in women than men.

True

False

7. In myasthenia gravis, plasmapheresis is used to remove what from the bloodstream?

Autoantibodies against the acetylcholine receptor

Excess acetylcholine

Muscle enzymes

Circulating corticosteroids

8. Which eye sign is commonly seen in myasthenia gravis due to ocular muscle weakness?

Ptosis and diplopia

Exophthalmos

Miosis (pinpoint pupils)

Nystagmus

9. A patient in myasthenic crisis presents with respiratory distress. What is the expected blood gas finding?

Respiratory acidosis with elevated CO₂

Respiratory alkalosis with low CO₂

Metabolic acidosis

Metabolic alkalosis

10. True or False: Myasthenia gravis symptoms typically improve with rest and worsen with activity.

True

False

11. Which medication is a long-term immunosuppressant used in myasthenia gravis management?

Pyridostigmine

Corticosteroids or azathioprine

Ephedrine

Atropine

12. Anticholinesterase inhibitors such as pyridostigmine work by doing what?

Preventing breakdown of acetylcholine, prolonging its action at the synapse

Reducing antibody production against the acetylcholine receptor

Stimulating muscle fiber contraction directly

Blocking acetylcholine reuptake into the presynaptic terminal

13. A patient with myasthenia gravis develops sudden severe muscle weakness and respiratory distress. What is the priority nursing action?

Prepare for intubation and notify the provider immediately

Administer the next dose of pyridostigmine

Have the patient perform ice-pack test

Start oxygen and monitor vital signs only

14. The edrophonium (Tensilon) test confirms myasthenia by temporarily improving muscle strength. How does it work?

Inhibits acetylcholinesterase, increasing acetylcholine at the synapse

Blocks autoantibodies from binding to receptors

Stimulates the thymus gland to reduce antibody production

Increases muscle fiber calcium sensitivity

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17. A cholinergic crisis is caused by excessive acetylcholine. Which sign distinguishes it from myasthenic crisis?

Pinpoint pupils, excessive salivation, and muscle fasciculations

Ptosis and diplopia only

Inability to swallow

Flaccid paralysis without autonomic symptoms

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21. Myasthenia gravis results from autoantibodies targeting which receptor?

Nicotinic acetylcholine receptor at the neuromuscular junction

Muscarinic acetylcholine receptor in the parasympathetic nervous system

GABA receptors in the spinal cord

Dopamine receptors in the basal ganglia

Myasthenia Quiz: Crisis or Cholinergic?

1. Which clinical sign is most characteristic of myasthenia gravis?

2.

What first name or nickname would you like us to use?

2. Which diagnostic test showing antibodies against acetylcholine receptors confirms myasthenia gravis?

3. True or False: Ice-pack test (applying ice to the eyes) can temporarily improve myasthenia gravis symptoms.

4. A patient with myasthenia gravis complains of difficulty chewing and swallowing. What nursing intervention is most appropriate?

5. Which neurotransmitter is deficient at the neuromuscular junction in myasthenia gravis?

6. True or False: Myasthenia gravis is more common in women than men.

7. In myasthenia gravis, plasmapheresis is used to remove what from the bloodstream?

8. Which eye sign is commonly seen in myasthenia gravis due to ocular muscle weakness?

9. A patient in myasthenic crisis presents with respiratory distress. What is the expected blood gas finding?

10. True or False: Myasthenia gravis symptoms typically improve with rest and worsen with activity.

11. Which medication is a long-term immunosuppressant used in myasthenia gravis management?

12. Anticholinesterase inhibitors such as pyridostigmine work by doing what?

13. A patient with myasthenia gravis develops sudden severe muscle weakness and respiratory distress. What is the priority nursing action?

14. The edrophonium (Tensilon) test confirms myasthenia by temporarily improving muscle strength. How does it work?

15. Thymectomy is considered in myasthenia gravis because the thymus is involved in____.

16. A cholinergic crisis caused by pyridostigmine overdose would be reversed by administering____.

17. A cholinergic crisis is caused by excessive acetylcholine. Which sign distinguishes it from myasthenic crisis?

18. In a myasthenic crisis, muscle weakness is due to insufficient____.

19. Muscle relaxants and certain antibiotics can worsen myasthenia gravis symptoms. These drugs are considered____.

20. In myasthenic crisis, the primary goal of nursing care is to maintain____ and prevent aspiration.

21. Myasthenia gravis results from autoantibodies targeting which receptor?