Forum: MRCP Part 2

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Comment on Question 10974

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  2. The Question:A 34-year-old man has recently been diagnosed with myasthenia gravis. He went on holiday to Wales and forgot to take his medication with him. On his return, his condition has significantly deteriorated, and he has been intubated on ITU. Unfortunately, his admission has been significantly complicated by a chest infection, which has required numerous different antibiotics in order to treat it. During his recovery from the sepsis, he developed cardiac conduction problems, which have also been treated. He has had 2 “seizure” type episodes. Electrophysiological testing reveals that his myasthenia has significantly deteriorated.
    Which of the following drugs is the most likely cause?Options: A. Bendrofluazide B. Amoxycillin C. Digoxin D. Gentamicin E. Sodium valproate F. Propanolol G. Lactulose H. Azathioprine I. Aspirin Answers: D, Teaching NotesAccording to the Oxford Handbook of clinical Medicine, B Blockers also adversely affect Myasthenia Gravis. Would an answer of propranolol not also be correct?

  3. You are right beta blockers could adversely affect MG, but in the given scenario this patient had cardiac conduction block in ITU , so it is less likely that he would have received beta blockers.
    More over he had a bad infection requiring several antibiotics and the best possible answer here would be gentamicin.

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