Which of the following is an autoimmune disease?

AIIMS BBSR SNO - 2019

Medical & Surgical Nursing

Easy

Appeared in: AIIMS BBSR SNO - 2019

Explanation

Myasthenia gravis is a classic autoimmune disorder where the body's immune system produces antibodies that attack and damage acetylcholine receptors at the neuromuscular junction.
This autoimmune attack impairs the transmission of nerve signals to muscles, leading to the hallmark symptoms of fluctuating muscle weakness and fatigue.
The presence of specific autoantibodies, such as anti-ACh receptor antibodies, in the blood of most patients confirms its autoimmune nature.
Unlike the other options, which are primarily neurodegenerative or metabolic, Myasthenia gravis fits the definition of an autoimmune disease perfectly.

Option A: The term 'Diabetes' is ambiguous. While Type 1 Diabetes is an autoimmune disease, Type 2 Diabetes, the more prevalent form, is a metabolic disorder. Without specification, it is not the best answer.
Option C: Parkinson's disease is a neurodegenerative disorder characterized by the progressive loss of dopamine-producing neurons in the brain. Its primary cause is not an autoimmune process.
Option D: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons. While inflammation is involved, it is not classified as a primary autoimmune disease where the immune system is the initial and direct cause of the pathology.

Clinical Relevance

Nursing practice connection: Knowing Identification of Autoimmune Diseases helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses caring for patients with Myasthenia Gravis must be vigilant in assessing for signs of respiratory distress, which can indicate a myasthenic crisis—a life-threatening complication.
Medication management is critical. Acetylcholinesterase inhibitors must be given on a strict schedule to maintain muscle strength and prevent symptom exacerbation.
Patient education should focus on energy conservation strategies, recognizing triggers that worsen symptoms (e.g., heat, stress, certain medications), and the importance of medication adherence.

How to Approach the Question

First, understand the question's core concept: it asks to identify an 'autoimmune disease'. Recall the definition of an autoimmune disease as a condition where the body's immune system attacks its own tissues.
Evaluate each option based on this definition.
Option A (Diabetes): Recognize that this is a broad term. Recall that Type 1 is autoimmune, but Type 2 is not. This ambiguity makes it a less certain answer.
Option B (Myasthenia gravis): Recall or deduce that this is a well-known autoimmune disease affecting the neuromuscular junction.
Option C (Parkinson's disease): Identify this as a neurodegenerative disorder related to dopamine deficiency, not autoimmunity.
Option D (Amyotrophic lateral sclerosis): Identify this as another neurodegenerative disorder affecting motor neurons.

Concept Tested & Keywords

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 1224-1226

E6 Medicine Harrison 22e Part 2 pp. 694-696, 995-997