Larynx and airway: fatigable voice of myasthenia: practice question

A ENT 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.

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ENT · Larynx and airway: fatigable voice of myasthenia

Sample item

A 30-year-old teacher's voice becomes weak and breathy after prolonged speaking and recovers after rest. She has evening ptosis. Laryngoscopy at rest is normal. What is the likely cause?

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

The answer and the reasoning

B. Myasthenia gravis

Fatigable weakness that worsens with use and improves with rest, with ocular signs, indicates a neuromuscular junction disorder. Laryngeal myasthenia may present as voice fatigue, so acetylcholine receptor antibodies and repetitive stimulation are indicated.

Option by option

  • A. Adductor spasmodic dysphonia

    Spasmodic dysphonia gives strained, strangled voice with spasms, not fatigue.

  • B. Myasthenia gravis (correct)

    Correct. Use-related fatigue with ptosis points to myasthenia gravis.

  • C. Vocal nodules

    Nodules cause persistent hoarseness with visible lesions on the folds.

  • D. Muscle tension dysphonia

    Muscle tension dysphonia shows hyperfunction and not ptosis.

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.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Myasthenia gravis. Fatigable weakness that worsens with use and improves with rest, with ocular signs, indicates a neuromuscular junction disorder.

Why is "Adductor spasmodic dysphonia" not the answer?

Spasmodic dysphonia gives strained, strangled voice with spasms, not fatigue.

Why is "Vocal nodules" not the answer?

Nodules cause persistent hoarseness with visible lesions on the folds.

Why is "Muscle tension dysphonia" not the answer?

Muscle tension dysphonia shows hyperfunction and not ptosis.

What concept does this question test?

It tests Larynx and airway: fatigable voice of myasthenia in ENT. Laryngeal myasthenia may present as voice fatigue, so acetylcholine receptor antibodies and repetitive stimulation are indicated.

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 Larynx and airway: fatigable voice of myasthenia?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.