Neuromuscular Disorders USMLE Step 1 Practice Question
A 42-year-old woman with myasthenia gravis and a recent upper respiratory infection presents with worsening dysphagia, nasal speech, and dyspnea. Vital signs show BP 128/82, HR 102, RR 22, SpO2 92% on room air. She cannot count past 5 on one breath. Serum creatinine is normal. Chest X-ray shows no infiltrates. She denies fever. She takes pyridostigmine daily but skipped doses during her illness. Which intervention is most appropriate immediately?
Answer choices
- AGive high dose haloperidol
- BAdminister dopamine agonist therapy
- CAssess ventilatory function and admit for respiratory supportCorrect answer
- DTreat with pralidoxime only
- EIncrease outpatient exercise and observe
- FPerform plasmapheresis and administer intravenous immunoglobulin
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