A 42-year-old woman presents with progressive fatigable ptosis and nasal speech. Vital signs show BP 128/82, HR 88, RR 16, Temp 37.2°C, SpO2 98% on room air. Serum anti-acetylcholine receptor antibodies are positive. Repetitive nerve stimulation demonstrates progressively decreasing compound muscle action potentials with 15% decrement. She denies diplopia. She takes no immunosuppressive medications. Which of the following best explains her neuromuscular disorder?

  1. A)Presynaptic P Q type voltage gated calcium channel antibodies
  2. B)Amyotrophic lateral sclerosis
  3. C)Postsynaptic nicotinic acetylcholine receptor antibodiesGABARITO
  4. D)Incremental response with repeated stimulation
  5. E)Botulism

Explicação

Myasthenia gravis is caused by autoantibodies against postsynaptic nicotinic acetylcholine receptors, which reduce end plate potentials and produce a decremental response on repetitive stimulation. Weakness worsens with repeated use because the safety margin o... Ver explicação completa e trilha adaptativa →

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