A 36-year-old woman with myasthenia gravis self-increased her pyridostigmine dose without medical supervision. She presents with generalized weakness, diarrhea, diaphoresis, and miosis. Vital signs show BP 128/76, HR 92, RR 18, temperature 37.2°C, and SpO2 98% on room air. Serum potassium is 3.1 mEq/L. She denies recent infections or medication changes besides pyridostigmine. Which mechanism best explains her current clinical deterioration?
- A)Voltage gated calcium channel antibodies from lung cancer
- B)Acute demyelinating polyneuropathy after infection
- C)Progression to ALS with autonomic failure
- D)Under-treatment of myasthenia causing only nicotinic receptor blockade
- E)Excess acetylcholine causing depolarization block with muscarinic symptomsGABARITO
Explicação
Excess acetylcholinesterase inhibition can produce cholinergic crisis, in which too much acetylcholine causes persistent depolarization and worsening weakness along with muscarinic symptoms such as diarrhea, sweating, and miosis. The muscarinic findings help d... Ver explicação completa e trilha adaptativa →