USMLE Question of the Week

Which Lab Test Is Appropriate for a Young Man With Shortness of Breath and Hemoptysis?

In Episode 31 of Med School Question of the Week for USMLE, Alisa Khomutova, MedSchoolCoach expert tutor, answers this medical school question: A 28-year-old man presents to the Ed with complaints of shortness of breath and hemoptysis over the past week. He has no known sick contacts. He has no PMH and drinks a few bottles of beer on the weekend. He takes no medications. His temperature is 37°C(98.6°F), pulse is 91/min, respirations are 21/min, and blood pressure is 148/89 mm Hg. Physical exam shows inspiratory crackles at both lung bases. The remainder of the exam is normal. His hemoglobin is 13.2 g/dL, leukocyte count is 9,900/mm, and platelet count is 199,000/mm. Urinalysis shows a proteinuria of 2+, 69 RBC/hbf, and 1-2 WBC/hbf. Chest x-ray shows pulmonary infiltrates. Further testing is most likely to show which of the following?
  • Increased anti-PLA2R antibodies
  • Increased serum IgA antibodies
  • Increased c-ANCA antibodies
  • Increased p-ANCA antibodies
  • Increased anti-GBM antibodies
  • Increased anti-dsDNA antibodies
Click to Reveal the Correct Answer

Increased anti-GBM antibodies

Alisa Khomutova

Alisa received her B.S. from University of California, Davis, and attended Oakland University William Beaumont School of Medicine. In 2020, she matched into Stony Brook Teaching Hospital practicing General Surgery for residency.

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