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Myasthenic crisis — ABEM Board MCQ

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HardNeurological emergenciesMyasthenic crisisABEM Board

A 61-year-old woman with myasthenia gravis arrives with dysphagia and dyspnea. Triage acuity is ESI 1; BP 136/74 mm Hg, HR 104/min, RR 30/min, SpO2 93%. She has ptosis, weak cough, and single-breath count of 8. She recently started levofloxacin. Which of the following is the most appropriate initial action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Prepare for early intubation with neurology consultation for IVIG or plasma exchange

Myasthenic crisis with bulbar weakness and poor ventilatory reserve needs early airway planning and disease-specific therapy.

Reference: Myasthenia Gravis Foundation guidance; emergency airway references