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Myasthenia Gravis — RACP Adult Medicine MCQ

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EasyNeurologyMyasthenia GravisRACP Adult Medicine

A 60-year-old woman presents with intermittent dysphagia predominantly for solids, diplopia worse at the end of the day, ptosis, and fatigable proximal weakness. Symptoms fluctuate and are worse with exertion. Anti-AChR antibodies are positive. CT thorax shows an anterior mediastinal mass. What is the most likely cause of dysphagia?

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Correct answer: B — Myasthenia gravis

Fatigable weakness with ptosis, diplopia, and dysphagia fluctuating throughout the day with positive anti-AChR antibodies and thymoma is myasthenia gravis. Thymoma is present in ~15% of MG patients. Treatment includes pyridostigmine (symptomatic), immunosuppression (prednisolone + azathioprine), and thymectomy (for thymoma and generalised MG).

Reference: eTG Neurology – 2024 – Myasthenia Gravis