A client presents to a health clinic complaining of several vague symptoms. As the history/physical continues, the health care provider clearly thinks the client may have myasthenia gravis

Question

Which statements by the client would correlate with this diagnosis? Select all that apply.
A) "Sometimes I have double vision."
B) "I have more energy in the morning but get worse as the day goes by."
C) "Sometimes I have numbness/tingling on my face."
D) "I had what felt like an electric shock race down the back of my leg when I bend my neck."
E) "I feel like I don't have enough energy to chew my food sometimes."

Answer 1

Ans: A, B, E
Feedback:
Now recognized as an autoimmune disease, myasthenia gravis is caused by an antibody-mediated destruction of acetylcholine receptors in the neuromuscular junction. This results in both muscle weakness and fatigability with sustained effort. Most commonly affected are the eye and periorbital muscles, with ptosis (drooping of eyelids) or diplopia (double vision) due to weakness of the extraocular muscles as an initial symptom. The disease may progress from ocular muscle weakness to generalized weakness. Chewing and swallowing may be difficult. In most persons, symptoms are least evident when arising in the morning, but grow worse with effort and as the day proceeds. Multiple sclerosis clients have paresthesias exhibited as numbness, tingling, burning sensations, or pressure on the face or involved extremities. The Lhermitte sign is an electric shock–like tingling down the back and onto the legs that is produced by flexion of the neck.