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Hello I have a 2003 Acura MDX that has a rough idle and is hard to start but until recently it ran great at driving speeds. Yesterday I noticed that it started to miss at highway speeds and it shook badly in D5 I had to shift into D4 to get it to run smooth, any ideas what it could be. It has 238k kms
 

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Look for common things - low fuel pressure / flow, check your timing (could be off a tooth), clogged cat(s), bad upstream O2 (Air/Fuel) sensors, air filter clogged, MAF sensor dirty / bad, PCV, etc., etc., etc.... though most will trigger at least some sort of other code.
 
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