Medical Surgical Myasthenia Gravis MG #5

Question

A client tells the nurse that she was just diagnosed with myasthenia gravis by her primary care provider and she is supposed to see a specialist. Which type of specialist would this client need to consult?

Answers

  1. Rheumatologist
    • Rationale:

      This answer is not correct because rheumatology is the study of rheumatic diseases, that is, diseases of the joints, muscles, and bones. Examples of these diseases would be rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and systemic lupus erythematosus.

  2. Ophthalmologist
    • Rationale:

      This answer is not correct because an ophthalmologist diagnoses and treats eye disorders. However, sometimes a client may require a consultation for surgery from an ophthalmologist due to ptosis from the myasthenia gravis disease process.

  3. Neurologist
    • Rationale:

      This answer is correct because neurology is a branch of medicine that cares for diseases of the nervous system, including their muscles and tissues. Myasthenia gravis is a disease of the neuromuscular junction which communicates with the muscles. Myasthenia gravis is treated with medications or surgery.

  4. Otolaryngologist
    • Rationale:

      This answer is not correct because an otolaryngologist is an ear, nose, and throat doctor who treats diseases of the head and neck. The client with myasthenia gravis may consult otolaryngology for dysphagia, which is a symptom of the disease.

Overview

Myasthenia gravis is an autoimmune neuromuscular disease which causes great fatigue and weakness of the voluntary muscles. Antibodies block receptors for acetylcholine at the neuromuscular junction which prevents muscular contraction. For this reason, neurologists specialize in myasthenia gravis.

Explanation

Learning Outcomes

Myasthenia gravis is an autoimmune neuromuscular disease which causes great fatigue and weakness of the voluntary muscles. The transition between where nerve cells bridge with muscles is impaired in clients with MG. Antibodies block receptors for acetylcholine at the neuromuscular junction which prevents muscular contraction. This ultimately results in voluntary muscle weakness causing fatigue, diplopia, facial paralysis, dysphagia, or ptosis.Treatment includes cholinesterase inhibitors which increase communication between the nerve cells and muscles and immunosuppressant drugs such as corticosteroids to suppress the body’s immune response. The last option is intravenous immunoglobulin therapy where the client receives normal antibodies to help strengthen the immune system. It would not be unusual for a client with myasthenia gravis to consult other specialties due to the symptoms myasthenia gravis causes but neurologists would be the main specialty to follow the person with MG.

Test Taking Tip

Know your medical terminology and which disease belongs with which speciality.

Video Rationale