A 34-year-old female presents with double vision and eyelid drooping worsening toward the evening. Repetitive nerve stimulation shows a decremental response, and anti-acetylcholine receptor (AChR) antibodies are positive. What is the first-line symptomatic medical therapy?

Answer and explanation

Correct answer: A. Pyridostigmine (oral acetylcholinesterase inhibitor)

  1. Step 1: Myasthenia gravis is an autoimmune disorder characterized by autoantibodies against nicotinic ACh receptors at the neuromuscular junction.
  2. Step 2: The oral acetylcholinesterase inhibitor pyridostigmine increases acetylcholine availability at the synaptic cleft, providing first-line symptomatic relief.
Answer
Pyridostigmine (oral acetylcholinesterase inhibitor).
Why not the others: 'Intravenous immunoglobulin (IVIG)' is reserved for acute myasthenic crisis; 'High-dose oral prednisone alone' is an immunosuppressive maintenance therapy added if cholinesterase inhibitors are insufficient; 'Plasma exchange (plasmapheresis)' is an emergency rescue therapy for impending respiratory failure.

Practise more Internal Medicine, Cardiology and Pulmonology.

Free questions with an explanation for every one, and full timed National Health Regulatory Authority Licensure Examination (NHRA Bahrain) mock tests.

All Internal Medicine, Cardiology and Pulmonology questionsTake a mock test

More Internal Medicine, Cardiology and Pulmonology questions

A 34-year-old femaleā€¦ | National Health Regulatory Authority Licensure Examination (NHRA Bahrain)