Which of the following contributory factors are likely responsible for the development of respiratory failure in patients who have myasthenia gravis? I. inspiratory muscle weakness II. expiratory muscle weakness III. susceptibility to venous thromboembolic disease IV. poor clearance of pulmonary secretions
A. I, II only
B. I, IV only
C. I, II, IV only
D, I, II, III, IV
ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Respiratory failure may occur secondary to a combination of weaknesses of the muscles of inspiration, expiration, and the pharyngeal airway. Airway muscle weakness predisposes to aspiration and obstruction, and loss of expiratory muscle strength leads to ineffective cough and poor clearance of secretions. Weak inspiratory muscles are unable to generate adequate Vts, resulting in atelectasis and pulmonary shunt.
D. Incorrect response: See explanation C
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