Myasthenia gravis Quiz: Ace Your Exams
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A 26-year-old woman, who is three weeks postpartum, presents to the emergency department for evaluation of weakness and difficulty breathing. Yesterday, her arm felt weak as she was brushing her hair, which she attributed to carrying her newborn baby. Today, she feels weaker and choked while eating breakfast and has had increased shortness of breath. She has a past medical history of asthma and uses albuterol as needed. She tried using her inhaler for the shortness of breath, but it failed to relieve her symptoms. She is currently being treated for a urinary tract infection with ciprofloxacin. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 30/min, blood pressure is 120/80 mmHg, and oxygen saturation is 94% on room air. On exam, she has bilateral ptosis, and 4/5 strength with neck flexion and bilateral shoulder abduction. She has 5/5 strength of the lower extremities bilaterally. Sensation and deep tendon reflexes are normal. Which of the following is the best next step in management?
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