A 25-year-old preschool teacher, Sandy 'Thompson, has not been feeling like herself lately. She has been feeling quite tired and her co-workers have commented on her droopy eyelids. Additionally, she is experiencing weakness in her arms and legs has difficulty talking clearly and even her students' parents have been concerned that Sandy hasn?t been looking very happy at work. One day at lunch, Sandy starred to choke on her food, causing one of her coworkers to perform the Heindich maneuver on her. While the scare didn't cause any permanent damage, Sandy is convinced that it is time to go see a doctor.

When she finally arrives at her appointment with Dr. Wayne, she explains to Dr. Wayne what has been going on, and the doctor decides to run a few blood tests. Sandy's blood work results are presented below.

5. Thompson?Test Results

Questions

1. What symptoms is she experiencing?

2. What levels from her blood work are abnormal?

3. How would antibodies against Ach receptors affect the neuromuscular junction?

4. How would antibodies against the Ach receptors affect the influx of Na* into the cell?

Blood Pressure Hematocrit (9) Glucose (mg/dl) Sodium (mmol/L) Test Potassium (mmol/L) ACHE Activity Test (96) Tetralodothyronine or thyroxine (T) (ng/dL) Serum Triiodothyronine (T) (ng/dl) Antibodies for ACh Receptors Result 115/73 36.5 94 144 4.3 100 11.3 154 Present Normal Range 90-120/60-80 36-38 70-110 135-145 3.5-5.0 100 4.6-12 80-180 Not Present