Glomerular Diseases USMLE Step 1 Practice Question
A 35-year-old woman with systemic lupus erythematosus presents with edema and dyspnea. Vital signs show BP 148/92 mmHg, HR 98/min, RR 20/min, and SpO2 98% on room air. Urinalysis demonstrates proteinuria (3.2 g/24 hours) and hematuria with RBC casts. Serum creatinine is 1.8 mg/dL. Laboratory studies reveal depressed C3/C4 levels, positive anti-dsDNA and anti-nucleosome antibodies. Renal biopsy shows subendothelial immune deposits with characteristic 'wire-loop' lesions. Complement levels are significantly reduced. Which lupus nephritis class is most likely?
Answer choices
- AClass III (focal proliferative)
- BClass VI (advanced sclerosing)
- CClass IV (diffuse proliferative)Correct answer
- DClass V (membranous)
- EClass II (mesangial proliferative)
- FClass I (minimal mesangial)
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