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Myasthenic crisis — ABEM Board MCQ

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HardNeurological emergenciesMyasthenic crisisABEM Board

A 58-year-old woman with myasthenia gravis presents as triage level 1 with dyspnea and weak cough after pneumonia. Vital capacity is 12 mL/kg, negative inspiratory force is -16 cm H2O, and oxygen saturation is 93%. Which of the following is the most important immediate intervention?

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Correct answer: C — Elective endotracheal intubation before respiratory arrest

Low vital capacity and weak inspiratory force indicate impending ventilatory failure in myasthenic crisis; oxygen saturation may remain deceptively normal.

Reference: Neurocritical Care myasthenic crisis guidance; ABEM EM Model