A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition?

Myasthenia gravis (MG)

Multiple sclerosis (MS)

Cerebral palsy (CP)

Parkinson disease (PD)

Answer and Explanation

The Correct Answer is A

A) Myasthenia gravis (MG):
Weakness of the extremities and diplopia (double vision) are hallmark symptoms of myasthenia gravis, an autoimmune disorder that affects the neuromuscular junction. In MG, antibodies attack acetylcholine receptors, leading to muscle weakness that worsens with activity and improves with rest. The weakness typically affects voluntary muscles, including those responsible for eye movement, which leads to symptoms such as diplopia and ptosis (drooping eyelids).

B) Multiple sclerosis (MS):
Multiple sclerosis involves the demyelination of neurons in the central nervous system, leading to a variety of neurological symptoms. While MS can cause weakness and visual disturbances, the typical symptoms of MS include fatigue, muscle spasticity, ataxia, and sensory deficits. Diplopia can occur in MS but is usually accompanied by other neurological signs such as numbness, tingling, or loss of coordination.

C) Cerebral palsy (CP):
Cerebral palsy is a group of disorders affecting movement and posture due to non-progressive brain injury or abnormal brain development, often occurring in early childhood. While CP can cause muscle weakness and coordination issues, it does not typically present with diplopia. Instead, it often involves spasticity, motor impairment, and difficulty with fine motor tasks.

D) Parkinson disease (PD):
Parkinson disease is characterized by tremors, bradykinesia (slowness of movement), rigidity, and postural instability. While PD can lead to muscle weakness and visual issues like blurred vision, it is not typically associated with diplopia as a primary symptom. The hallmark motor symptoms are primarily related to tremor and difficulty initiating movements rather than generalized weakness and double vision.

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Correct Answer is C

Explanation

A) Are no longer approved for treating depression: MAO inhibitors (MAOIs) are still approved and used to treat depression, especially in cases where other medications have not been effective. They are not considered obsolete, though their use has become less common due to the availability of safer, more tolerable options. This is not the primary reason why MAOIs may not be prescribed.

B) Are more expensive than other antidepressants: While cost can be a factor in medication choice, it is not the primary reason why MAO inhibitors are less frequently prescribed for depression. There are other more significant concerns, such as side effects and dietary restrictions, that make other medications a preferred first-line choice.

C) Require strict dietary restrictions: This is the most accurate explanation. MAO inhibitors can cause dangerous interactions with certain foods that contain high levels of tyramine, such as aged cheeses, cured meats, and fermented products. Consuming these foods while on an MAOI can lead to a hypertensive crisis, which is a life-threatening condition. Because of these dietary restrictions, patients on MAOIs must adhere to a strict diet, which can be challenging to manage.

D) Can cause profound hypotension: While hypotension can occur as a side effect of MAOIs, it is not the most significant concern. The more serious risk with MAOIs is the potential for a hypertensive crisis due to dietary interactions with tyramine-containing foods, rather than hypotension. Therefore, the dietary restrictions are a more pressing issue than the risk of hypotension.

A. Increased intraocular pressure B. Decreased blood pressure C. Decreased heart rate D. Increased respiration

Correct Answer is A

Explanation

A) Increased intraocular pressure: Sympathomimetic drugs stimulate the sympathetic nervous system and promote "fight or flight" responses, often resulting in vasoconstriction and other effects. Some sympathomimetics, especially those that affect alpha-adrenergic receptors, can lead to increased intraocular pressure, which is a concern in conditions like glaucoma.

B) Decreased blood pressure: Sympathomimetic drugs generally increase blood pressure by stimulating alpha and beta receptors that cause vasoconstriction and increased heart rate. In contrast, drugs that would decrease blood pressure are usually parasympathomimetics or other agents designed to block sympathetic responses.

C) Decreased heart rate: Sympathomimetic drugs typically increase heart rate by stimulating beta-1 adrenergic receptors in the heart. These drugs are used in situations requiring increased cardiac output or to counteract bradycardia. Decreased heart rate would typically occur with parasympathomimetic drugs or medications that block sympathetic activity (e.g., beta blockers).

D) Increased respiration: Sympathomimetic drugs can increase respiratory rate by promoting bronchodilation through beta-2 adrenergic receptor activation in the lungs. However, "increased respiration" as a general effect is not as specific or consistent as the other cardiovascular and ocular effects of these drugs. The primary and most prominent physiological change would be related to the cardiovascular effects.

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A patient reports weakness of the extremities and diplopia. The nurse knows that these symptoms are characteristic of which condition?

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Explanation

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Correct Answer is A

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