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Myasthenic crisis — RCPSC EM MCQ

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HardNeurological emergenciesMyasthenic crisisRCPSC EM

A 44-year-old with myasthenia gravis presents with dysphagia and dyspnoea after pneumonia symptoms. Single-breath count is 8, FVC is 12 mL/kg, and ABG shows rising PaCO2. Oxygen saturation is 96% on nasal prongs. What is the most appropriate disposition?

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Correct answer: EICU admission for ventilatory monitoring and immunomodulatory therapy

ICU admission for ventilatory monitoring and immunomodulatory therapy is correct: the clues indicate Myasthenic crisis and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian neuromuscular respiratory emergency practice