Ptosis and diplopia worsening with sustained activity are characteristic ocular signs of myasthenia gravis, reflecting fatigable weakness. Other options describe Parkinson's (rigidity/bradykinesia), ALS (fasciculations/atrophy), or Parkinson's tremor (resting tremor).
심화 해설
Clinical Judgment
This question assesses the ability to identify the most specific physical examination finding for Myasthenia Gravis. The key is understanding the nature of the disease—"muscle weakness that worsens with activity and improves with rest"—and selecting the objective assessment method that most clearly demonstrates this. Option 4, "ptosis that worsens with sustained upward gaze," is a specific finding that directly demonstrates the core pathology of muscle fatigability, which a nurse can observe by watching the patient's facial expressions and eye movements during conversation. The other options are more characteristic of other neurological conditions, such as Parkinson's disease or Guillain-Barré syndrome.
Memory Tip:
The hallmark of Myasthenia Gravis is Fatigable Weakness. Remember the mnemonic: "Myasthenia Gravis gets Grave with Gravity." Muscles that work against gravity, such as lifting the eyelids or arms, become particularly weak.
KR vs US:
In Korea, neurologists primarily perform the Tensilon (edrophonium) test or antibody tests to diagnose Myasthenia Gravis. In the US NGN/CJMM, the nurse's initial assessment and clinical judgment are emphasized more as the first step in the diagnostic process. As in this question, the ability to recognize specific signs that a nurse can detect during history-taking and physical examination is very important.
학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.