Glomerular Diseases USMLE Step 1 Practice Question
A 35-year-old man with systemic lupus erythematosus presents with hematuria and dysuria. Vital signs show BP 145/92 mmHg, HR 88/min, RR 16/min, temperature 37.2°C, SpO2 98%. Urinalysis reveals pyuria, cellular casts, and 2 g/day proteinuria. Serum creatinine is 1.4 mg/dL. Kidney biopsy demonstrates endocapillary proliferation with wire-loop lesions and subendothelial immune deposits. C3 and C4 are markedly reduced. Complement-fixing antibody titers are elevated. No pulmonary hemorrhage noted. Which lupus nephritis class does this represent?
Answer choices
- AClass I (minimal mesangial)
- BClass IV (diffuse proliferative)Correct answer
- CClass V (membranous)
- DClass III (focal proliferative)
- EClass II (mesangial proliferative)
- FClass VI (advanced sclerosing)
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