nerdexam
Test_Prep

USMLE · Question #610

A 40-year-old male comes to the emergency department due to a two-week history of a productive cough that is occasionally associated with blood. He has had similar episodes in the past. Vitals reveal

The correct answer is A. anti-basement membrane antibodies. This patient most likely has Good pasture syndrome which is a type of rapidly progressive glomerulonephritis characterized by the presence of autoantibodies to the glomerular and alveolar basement membranes. It usually presents with hemoptysis, glomerulonephritis and hematuria. G

Abnormal Processes

Question

A 40-year-old male comes to the emergency department due to a two-week history of a productive cough that is occasionally associated with blood. He has had similar episodes in the past. Vitals reveal a blood pressure of 140/80 mmHg, a heart rate of 75/min, a temperature of 37.6°C (99 6°F) and a respiratory rate of 16/ min. Oxygen saturation is 90% on room air. Laboratory results are as follows: Complete blood count - Hemoglobin 11.8 g/dL - Hematocrit 35.4% Mean Corpuscular Volume 85 ֲ μmֲ3 Leukocytes10,000/mmֲ3 - Differential: Neutrophils 60% Bands 3% Lymphocytes 25% Monocytes 7% Eosinophils 3%, Liver function studies - Alanine aminotransferase " 15 U/L Aspartate aminotransferase " 90 U/L Serum chemistry Creatinine " 1.5 mg/dL Blood urea nitrogen " 23 mg/dL - Urinalysis - blood, red blood cell casts. + The most likely other finding in this patient's serum is

Options

  • Aanti-basement membrane antibodies
  • Banti-double stranded DNA antibodies
  • Canti-mitochondrial antibodies
  • Danti-myeloperoxidase antibodies
  • Eanti-proteinase 3 antibodies

How the community answered

(38 responses)
  • A
    76% (29)
  • B
    13% (5)
  • C
    3% (1)
  • D
    5% (2)
  • E
    3% (1)

Explanation

This patient most likely has Good pasture syndrome which is a type of rapidly progressive glomerulonephritis characterized by the presence of autoantibodies to the glomerular and alveolar basement membranes. It usually presents with hemoptysis, glomerulonephritis and hematuria. Good pasture syndrome is an example of a type II cytotoxic hypersensitivity reaction. Laboratory findings include a linear pattern of IgG deposition within glomeruli on fluorescent antibody testing. Treatment is with plasmapheresis.

Topics

#Goodpasture syndrome#anti-GBM antibodies#pulmonary hemorrhage#autoimmune nephritis

Community Discussion

No community discussion yet for this question.

Sign up to join the discussion
Full USMLE Practice