CASE: A 19 year old Caucasian female from Canton, Ohio, is taken to her doctor’s office one afternoon by a co-worker after she had experienced stroke-like symptoms. Per the co-worker: the patient was working at her day job at Amazon, lifting boxes and placing them on conveyor belts. She was lifting a small box of “Keeping Up With the Kardashians” memorabilia, when she experienced the sudden onset of weakness in her bilateral upper extremities. Her co-worker noticed her friend standing in place with her arms extended and, confused, rushed her to the infirmary at the factory, after which she was told to go to her doctor. After questioning, the patient did state that she has experienced intermittent, occasional weakness which usually worsened as the day progressed. Throughout the day, she notices that her eyelids become progressively more droopy over time but that as she rests, her strength improves. After gathering this history, her physician decides to test her for a disorder known as myasthenia gravis by testing for the presence of nicotinic acetylcholine receptor antibodies. Given a POSITIVE result on this testing, the patient was subsequently diagnosed with myasthenia gravis. Please address the following: Given the normal physiology of the neuromuscular junction, what clinical findings would you expect in a patient with myasthenia gravis?
CASE: A 19 year old Caucasian female from Canton, Ohio, is taken to her doctor’s office one afternoon by a co-worker after she had experienced stroke-like symptoms. Per the co-worker: the patient was working at her day job at Amazon, lifting boxes and placing them on conveyor belts. She was lifting a small box of “Keeping Up With the Kardashians” memorabilia, when she experienced the sudden onset of weakness in her bilateral upper extremities.
Her co-worker noticed her friend standing in place with her arms extended and, confused, rushed her to the infirmary at the factory, after which she was told to go to her doctor. After questioning, the patient did state that she has experienced intermittent, occasional weakness which usually worsened as the day progressed. Throughout the day, she notices that her eyelids become progressively more droopy over time but that as she rests, her strength improves.
After gathering this history, her physician decides to test her for a disorder known as myasthenia gravis by testing for the presence of nicotinic acetylcholine receptor antibodies. Given a POSITIVE result on this testing, the patient was subsequently diagnosed with myasthenia gravis.
Please address the following:
- Given the normal physiology of the neuromuscular junction, what clinical findings would you expect in a patient with myasthenia gravis?
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