NSG 232 Exam #3 Part 2-Questions with Correct Answers/
Verified/ Latest Update
Myasthenia gravis (MG) - ✔✔a chronic autoimmune neuromuscular disease; a lack of nerve
impulses and muscle responses at the myoneural junction, causes fatigue and muscular
weakness of the respiratory system, facial muscles, and extremities
Because of cranial nerve involvement, what often occurs with Myasthenia gravic? -
✔✔ptosis (drooping eyelid) and difficulty chewing and swallowing
The symptoms of MG are caused by: - ✔✔inadequate secretion of acetylcholine (ACh) or a
loss of ACh because of an increase in the enzyme acetylcholinesterase
Multpile sclerosis is - ✔✔an autoimmune neuromuscular disorder that attacks the myelin
sheath of nerve fibers in the brain and spinal cord, causing lesions known as plaques
Muscle spasms have various causes including - ✔✔injury or motor neuron disorders that
lead to conditions such as cerebral palsy, MS, spinal cord injuries, cerebral vascular accident,
or hemiplegia
Spasticity of muscles can be reduced with the use of - ✔✔skeletal muscle relaxants
MG is not a genetic disorder, but - ✔✔there can be familial tendency
MG results from - ✔✔lack of ACh at receptor sites because the body's immune system has
an antibody response against an alpha subunit of the ACh receptor sites, meaning
antibodies attack the sites making it to where ACh cannot bind to the site
AChR means - ✔✔acetylcholine receptor
What happens when ACh cannot bind to the muscle receptor sites? - ✔✔ineffective muscle
contraction and muscle weakness
,About 90% of clients with MG have _____ that can be detected through serum testing -
✔✔anti-acetylcholine antibodies
The thymus gland is involved in systemic immunity that is active during infancy and early
childhood, but it normally - ✔✔shrinks during adulthood
Approximately 60% of MG clients have - ✔✔thymic hyperplasia
Myasthenia gravis is characterized primiarily by - ✔✔weakness and fatigue of the skeletal
muscles
Early symptoms of MG are - ✔✔ptosis (drooping eyelid) and diplopia (double vision)
The group of drugs used to control MG is - ✔✔AChE inhibitors
AChE inhibitors inhibit the action of - ✔✔cholinesterase
What may occur when muscular weakness of a client with MG becomes generalized? -
✔✔myasthenia crisis
What can relieve myasthenia crisis? - ✔✔Neostigmine (a fast -acting AChE inhibitor)
Overdosing with AChE inhibitors might cause another crisis called - ✔✔cholinergic crisis
Cholinergic crisis is - ✔✔an acute exacerbation of symptoms of MG
Accompanying symptoms of cholinergic crisis include: - ✔✔miosis (abnormal pupil
constriction), pallor, sweating, vertigo, excess salivation, nausea, vomiting, abdominal craps,
diarrhea, bradycardia, and fasciculations (involuntary muscle twitching)
,Neostigmine (Prostigmine) is - ✔✔a short-acting AChE inhibitor with a half life of 0.5 to 1
hour, given for MG
What is usually given to a client with MG who does not respond to neostigmine or
pyridostigmine? - ✔✔Ambenonium chloride (Mytelase)
Because of its short half life, pyridostigmine must be given - ✔✔several times a day
What can be given for pyridostigmine overdose? - ✔✔atropine sulfate
What may clients who do not respond to AChE inhibitors require? - ✔✔prednisone or
immunosuppressive drugs
Overdosing and underdosing of AChE inhibitors have similar symptoms which include: -
✔✔muscle weakness, dyspnea, and dysphagia
Underdosing may result in myasthenia crisis, and overdosing may result in - ✔✔cholinergic
crisis
What is a short-acting AChE inhibitor that may be used to distinguish between myashenia
crisis and cholinergic crisis? - ✔✔Edrophonium chloride
After administering Edrophonium chloride to a patient how can you tell if the cause of the
symptoms was from myasthenia crisis? - ✔✔if symptoms were alleviated because of an
increase of ACh
After administering Edrophonium chloride to a patient how can you tell if the cause of the
symptoms was from cholinergic crisis? - ✔✔if muscle weakness becomes more severe
, Why can Edrophonium be used to diagnose MG? - ✔✔because its ultra-short duration of 5-
20 minutes increases muscle strength immediately; if ptosis is immediately corrected, the
Dx is most likely MG
Available laboratory tests that may suggest MS include: - ✔✔eleveated immunoglobulin G
(IgG) in cerebrospinal fluid, increased IgG/albumin ratio, and multiple lesions observable
through MRI
What are the goals for treatment strategies of MS? - ✔✔to decrease the inflammatory
process of nerve fibers and improve conduction of demyelinated axons
Clients with MS should avoid the following drugs: - ✔✔histamine (H2) blockers such as
cimetidine and ranitidine, indomethacin (an NSAID), and beta blockers
Name the drugs that are given for Myasthenia gravis: - ✔✔ambenonium (Mytelase),
edrophonium Cl (Tensilon), neostigmine bromide (Prostigmin), pyridostigmine bromide
(Mestinon)
What are the common characteristics associated with the acute attack phase of MS? -
✔✔fatigue; motor weakness; optic neuritis
What are the common characteristics associated with the remission-exacerbation phase of
MS? - ✔✔recurrence of clinical MS symptoms; spasticity
What are the common characteristics associated with the chronic progressive phase of MS?
- ✔✔progressive MS symptoms (wheelchair bound)
What are the treatment strategies for the acute attack phase of MS? - ✔✔tapering course
of glucocorticoids (prednisone); ACTH stimulares the adrenal cortex to secrete cortisol
What are the treatment strategies for the remission-exacerbation phase of MS? -
✔✔biologic immune response modifiers (BRMs), immunosuppressant drugs (e.g. Imuran),
interferons
Verified/ Latest Update
Myasthenia gravis (MG) - ✔✔a chronic autoimmune neuromuscular disease; a lack of nerve
impulses and muscle responses at the myoneural junction, causes fatigue and muscular
weakness of the respiratory system, facial muscles, and extremities
Because of cranial nerve involvement, what often occurs with Myasthenia gravic? -
✔✔ptosis (drooping eyelid) and difficulty chewing and swallowing
The symptoms of MG are caused by: - ✔✔inadequate secretion of acetylcholine (ACh) or a
loss of ACh because of an increase in the enzyme acetylcholinesterase
Multpile sclerosis is - ✔✔an autoimmune neuromuscular disorder that attacks the myelin
sheath of nerve fibers in the brain and spinal cord, causing lesions known as plaques
Muscle spasms have various causes including - ✔✔injury or motor neuron disorders that
lead to conditions such as cerebral palsy, MS, spinal cord injuries, cerebral vascular accident,
or hemiplegia
Spasticity of muscles can be reduced with the use of - ✔✔skeletal muscle relaxants
MG is not a genetic disorder, but - ✔✔there can be familial tendency
MG results from - ✔✔lack of ACh at receptor sites because the body's immune system has
an antibody response against an alpha subunit of the ACh receptor sites, meaning
antibodies attack the sites making it to where ACh cannot bind to the site
AChR means - ✔✔acetylcholine receptor
What happens when ACh cannot bind to the muscle receptor sites? - ✔✔ineffective muscle
contraction and muscle weakness
,About 90% of clients with MG have _____ that can be detected through serum testing -
✔✔anti-acetylcholine antibodies
The thymus gland is involved in systemic immunity that is active during infancy and early
childhood, but it normally - ✔✔shrinks during adulthood
Approximately 60% of MG clients have - ✔✔thymic hyperplasia
Myasthenia gravis is characterized primiarily by - ✔✔weakness and fatigue of the skeletal
muscles
Early symptoms of MG are - ✔✔ptosis (drooping eyelid) and diplopia (double vision)
The group of drugs used to control MG is - ✔✔AChE inhibitors
AChE inhibitors inhibit the action of - ✔✔cholinesterase
What may occur when muscular weakness of a client with MG becomes generalized? -
✔✔myasthenia crisis
What can relieve myasthenia crisis? - ✔✔Neostigmine (a fast -acting AChE inhibitor)
Overdosing with AChE inhibitors might cause another crisis called - ✔✔cholinergic crisis
Cholinergic crisis is - ✔✔an acute exacerbation of symptoms of MG
Accompanying symptoms of cholinergic crisis include: - ✔✔miosis (abnormal pupil
constriction), pallor, sweating, vertigo, excess salivation, nausea, vomiting, abdominal craps,
diarrhea, bradycardia, and fasciculations (involuntary muscle twitching)
,Neostigmine (Prostigmine) is - ✔✔a short-acting AChE inhibitor with a half life of 0.5 to 1
hour, given for MG
What is usually given to a client with MG who does not respond to neostigmine or
pyridostigmine? - ✔✔Ambenonium chloride (Mytelase)
Because of its short half life, pyridostigmine must be given - ✔✔several times a day
What can be given for pyridostigmine overdose? - ✔✔atropine sulfate
What may clients who do not respond to AChE inhibitors require? - ✔✔prednisone or
immunosuppressive drugs
Overdosing and underdosing of AChE inhibitors have similar symptoms which include: -
✔✔muscle weakness, dyspnea, and dysphagia
Underdosing may result in myasthenia crisis, and overdosing may result in - ✔✔cholinergic
crisis
What is a short-acting AChE inhibitor that may be used to distinguish between myashenia
crisis and cholinergic crisis? - ✔✔Edrophonium chloride
After administering Edrophonium chloride to a patient how can you tell if the cause of the
symptoms was from myasthenia crisis? - ✔✔if symptoms were alleviated because of an
increase of ACh
After administering Edrophonium chloride to a patient how can you tell if the cause of the
symptoms was from cholinergic crisis? - ✔✔if muscle weakness becomes more severe
, Why can Edrophonium be used to diagnose MG? - ✔✔because its ultra-short duration of 5-
20 minutes increases muscle strength immediately; if ptosis is immediately corrected, the
Dx is most likely MG
Available laboratory tests that may suggest MS include: - ✔✔eleveated immunoglobulin G
(IgG) in cerebrospinal fluid, increased IgG/albumin ratio, and multiple lesions observable
through MRI
What are the goals for treatment strategies of MS? - ✔✔to decrease the inflammatory
process of nerve fibers and improve conduction of demyelinated axons
Clients with MS should avoid the following drugs: - ✔✔histamine (H2) blockers such as
cimetidine and ranitidine, indomethacin (an NSAID), and beta blockers
Name the drugs that are given for Myasthenia gravis: - ✔✔ambenonium (Mytelase),
edrophonium Cl (Tensilon), neostigmine bromide (Prostigmin), pyridostigmine bromide
(Mestinon)
What are the common characteristics associated with the acute attack phase of MS? -
✔✔fatigue; motor weakness; optic neuritis
What are the common characteristics associated with the remission-exacerbation phase of
MS? - ✔✔recurrence of clinical MS symptoms; spasticity
What are the common characteristics associated with the chronic progressive phase of MS?
- ✔✔progressive MS symptoms (wheelchair bound)
What are the treatment strategies for the acute attack phase of MS? - ✔✔tapering course
of glucocorticoids (prednisone); ACTH stimulares the adrenal cortex to secrete cortisol
What are the treatment strategies for the remission-exacerbation phase of MS? -
✔✔biologic immune response modifiers (BRMs), immunosuppressant drugs (e.g. Imuran),
interferons
