Systemic paediatrics: juvenile myasthenia gravis: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pediatrics · Systemic paediatrics: juvenile myasthenia gravis

Sample item

A 10-year-old has drooping of both eyelids and double vision that worsen towards evening and improve after rest. Repetitive nerve stimulation shows a decremental response. Which drug is the first-line symptomatic treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Pyridostigmine

Myasthenia gravis causes fatigable weakness from antibodies against the acetylcholine receptor. Pyridostigmine, an acetylcholinesterase inhibitor, is the first-line symptomatic treatment. Immunotherapy and thymectomy are added when symptoms are not controlled.

Option by option

  • A. Azathioprine

    Azathioprine is a steroid-sparing immunosuppressant with delayed onset.

  • B. Prednisolone

    Prednisolone is added if pyridostigmine alone is inadequate, and it is not the first symptomatic drug.

  • C. Pyridostigmine (correct)

    Correct. Pyridostigmine prolongs acetylcholine action at the neuromuscular junction and gives symptomatic relief.

  • D. Intravenous immunoglobulin

    Intravenous immunoglobulin is reserved for crisis or severe disease, not first-line symptomatic treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Pyridostigmine. Myasthenia gravis causes fatigable weakness from antibodies against the acetylcholine receptor.

Why is "Azathioprine" not the answer?

Azathioprine is a steroid-sparing immunosuppressant with delayed onset.

Why is "Prednisolone" not the answer?

Prednisolone is added if pyridostigmine alone is inadequate, and it is not the first symptomatic drug.

Why is "Intravenous immunoglobulin" not the answer?

Intravenous immunoglobulin is reserved for crisis or severe disease, not first-line symptomatic treatment.

What concept does this question test?

It tests Systemic paediatrics: juvenile myasthenia gravis in Pediatrics. Pyridostigmine, an acetylcholinesterase inhibitor, is the first-line symptomatic treatment. Immunotherapy and thymectomy are added when symptoms are not controlled.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: juvenile myasthenia gravis?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.