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1. A 36-year-old woman has dysarthria, dysphagia, and neck weakness, with little ocular involvement. She tests MuSK-Ab positive. Which statement best describes the immunopathology of her disease?
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IgG1/IgG3 antibodies activate complement and destroy the postsynaptic folds
Her thymus is likely to show lymphofollicular hyperplasia, similar to early-onset AChR-Ab+ MG
Mainly IgG4 antibodies disrupt AChR clustering, and the postsynaptic membrane stays relatively preserved
The antibodies mainly block acetylcholine release from the nerve terminal
2. A 42-year-old man has new-onset generalized MG and is AChR-Ab positive. Additional testing shows anti-titin and anti-ryanodine receptor antibodies. How should these results be interpreted?
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They fit early-onset MG with thymic hyperplasia, so no further evaluation is needed
They raise concern for thymoma-associated MG and call for chest imaging
They suggest a coexisting MuSK-Ab+ subtype, so MuSK testing should be repeated
They are nonspecific in MG and add nothing to classifying the subgroup
3. Which finding from the phase 3 MINT Trial of the anti-CD19 antibody inebilizumab is accurate?
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Inebilizumab significantly improved MG-QOL15r vs placebo at week 26 in the combined population
Significantly more patients on inebilizumab than on placebo reached the 5 mg/day prednisone target
The trial enrolled only AChR-Ab+ patients because the MuSK-Ab+ subtype was excluded
Inebilizumab improved MG-ADL vs placebo at week 26 (−4.2 vs −2.2) and lowered the risk of exacerbations in the combined population
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