35 yr female with double vision at the end of the day, dysphagia, nasal voice, upp ext weakness, her sx improve after a night’s sleep.

1) Dx?
2) What is MG?
3) Best initial test for MG?
4) What is the specific test for MG?
5) What is the sensitive test for MG?
6) Most accurate test for MG?

1) Myasthenia Gravis
2) Dis. Of NMJ, presents with weakness and fatigue. Ab to Ach receptors -> dec # of active/functional Ach receptors at postsynaptic membrane
3) Ach receptor Ab
4) Fatigued muscle weakness plus +Ach receptor Ab test
5) Edrophonium (Tensilon) test
6) EMG (decremental dec in muscle fiber content on repetitive nerve stimulation

this is from SS you can download it in the free step 2 internal medicine download section