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A 35-Year-Old Woman Comes to the Emergency Department with Progressively

question 77

Multiple Choice

A 35-year-old woman comes to the emergency department with progressively worsening dyspnea and generalized weakness. She has had a month of double vision and difficulty swallowing that are significantly worse toward the end of the day. Over the past 2 weeks, she has had difficulty raising her arms above her head and walking up and down stairs. The patient has no headache, speech difficulty, muscle aches, numbness, or paresthesias. She also has no rash, insect bites, recent travel, or illness.
On physical examination, the patient has fatigable horizontal binocular diplopia in the primary position and bilateral ptosis. Strength is 4 on a scale of 5 in the proximal muscles of the upper and lower extremities. Sensory examination and reflex testing are unremarkable.
Complete blood count, comprehensive metabolic panel, and chest x-ray are normal. Vital capacity obtained at the bedside is 500 mL. The patient's respiratory status decompensates, requiring endotracheal intubation and admission to the intensive care unit.
Which of the following therapies is the most appropriate for rapidly improving this patient's current condition?

Definitions:

Carrier-Mediated Processes

Biological transport mechanisms in which specific carrier proteins facilitate the movement of molecules across cell membranes.

Lipid-Soluble Molecules

Molecules that can easily cross cell membranes due to their solubility in lipids, affecting the transport and signaling within cells.

Plasma Membrane

A bilayer of lipids and proteins that forms the external boundary of the cytoplasm of a cell, regulating the passage of molecules in and out of the cell.

Skeletal Muscle Cells

Skeletal muscle cells are long, cylindrical cells that make up skeletal muscles, responsible for voluntary movements of the body by contracting in response to voluntary nervous signals.