<prompt> All are clinical features of myasthenia gravis, EXCEPT:Spontaneous remissionAbsent deep tendon reflexesProximal muscle involvementWorsen by exeion  <response>: Answer is B Absent deep tendon reflexes: Despite the muscle weakness, deep tendon reflexes are preserved -- Harrison 16th2519; Harrison 17th 2673 Suspect Myaesthenia gravis in a case of weakness with fatiguability, without loss of reflexes impairment of sensations -- Harrison Mvaesthenia Gravis : Review : Etiology : Autoimmune disorders mediated by specific Anti ACH receptor antibodies. Fundamental defect : Decrease in number of available ACH receptors at post synaptic muscle membrane. Age Sex : All ages are affected Most prevalent in women in twenties thiies and men in fifties sixties. Women are affected more frequently than menQ. 3 : 2 Features : Weakness : in characteristic distribution as elaborated below Fatiguability: Weakness increases on repeated use and may improve following rest or sleep A variable course marked by remissions and exacerbations remissions are rarely complete or permanent Association : Thymic abnormalities and Thymomas Neoplastic Autoimmune disorders : Rheumatoid Ahritis, SLE, Perenicious anemia, hypehyroidism, ulcerative colitis, polymyositis etc. 