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Author [[PageAuthor::Ahmed Zaghw, M.D. [1]]]
Exam Type USMLE Step 2 CK
Main Category
Sub Category
Prompt A 45 year old female comes to the clinic with a weakness and not feeling well. She has been in a bad mood since she has lost her two sons in car accident two months ago. Since then, she has been worried about a lot of issues in her life. She has sought a psychiatric consultation for the frequent nightmares, emotional breakdown and panic attacks. She also noticed that he has difficulty raising his right eyelid for the last 6 weeks. His medical history is significant for a rheumatoid arthritis has failed to respond to DMARDs for the last 3 years. she drinks a couple beers at weekends. She does not smoke nor take illicit drugs. Her medications are etanercept, analgesics and fluxetine. The physical examination shows a ptosis of bilateral eye lids, however the extraocular muscles movement is intact. The full neurological examination does not reveal any abnormality. What would be the best confirmatory test to diagnose the disease ?
Answer A Antibodies to the MUscle specific tyrosine Kinase receptor(MuSK)
Answer A Explanation Incorrect.
Answer B Tensilon test
Answer B Explanation Incorrect.
Answer C Acetylcholine receptor antibodies
Answer C Explanation Correct.
Answer D Repetitive nerve stimulation test
Answer D Explanation Incorrect.
Answer E Single-fiber electromyography
Answer E Explanation Incorrect.
Right Answer C
Explanation Educational Objective:

Myasthenia gravis is associated with rheumatoid arthritis. Typically the Ocular myasthenia involves both eyes symmetrically.
Educational Objective:

Approved No
Keyword Myasthenia gravis
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