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9218 Pathology

A 25-year-old man presents with a progressive illness of several days’ duration characterized by nonproductive cough, fever, and malaise. A lateral view chest radiograph reveals platelike atelectasis. Elevated titers of cold agglutinins are detected. Which of the following is the most likely type of pneumonia in this patient?

ABacterial pneumonia, most likely caused by S. pneumoniae
BHospital-acquired pneumonia, most likely caused by P. aeruginosa
CInterstitial pneumonia, most likely caused by M. pneumoniae
DP. jiroveci (carinii) pneumonia, most likely related to an immunocompromised state
Pathology
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9219 Pathology

A 46-year-old woman has had worsening malaise for the past 36 hours. Her urine output is markedly diminished, and it has a cloudy brown appearance. On examination, she has periorbital edema. Laboratory findings include serum creatinine of 2.8 mg/dL and urea nitrogen of 30 mg/dL. A renal biopsy is performed and on microscopic examination shows focal necrosis in glomeruli with glomerular basement membrane breaks and crescent formation. No immune deposits are identified with immunofluorescence. Which of the following autoantibodies is most likely detectable in her serum?

AAnti-DNA topoisomerase antibody
BAnti-glomerular basement membrane antibody
CAnti-neutrophil cytoplasmic autoantibody
DAntinuclear antibody
Pathology
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