**Core Concept**
Glomerulonephritis can be mediated by various mechanisms, including immune complex deposition, complement activation, and direct antibody-mediated injury. In the context of a recent streptococcal infection, immune complex-mediated glomerulonephritis is a likely diagnosis.
**Why the Correct Answer is Right**
The patient's recent history of a group A beta-hemolytic streptococcal infection, along with the presentation of hypertension, oliguria, and hematuria, is classic for post-streptococcal glomerulonephritis (PSGN). PSGN is characterized by the formation of immune complexes consisting of streptococcal antigens and host antibodies, which deposit in the glomeruli and activate the complement system. Immunofluorescence staining for C3, a component of the complement system, is often positive in PSGN. However, the strongest evidence of immune complex-mediated glomerulonephritis would be the presence of IgG, IgM, or both, which are the antibodies that form the immune complexes.
**Why Each Wrong Option is Incorrect**
**Option A:** Complement factor C3 is involved in the immune response, but its presence is not as specific for immune complex-mediated glomerulonephritis as IgG or IgM.
**Option B:** C1q is a component of the classical pathway of complement activation, which is involved in immune complex-mediated responses, but its presence is not as specific for PSGN as IgG or IgM.
**Option C:** Fibrinogen is an acute-phase reactant and is often present in the glomeruli in various types of glomerulonephritis, but its presence is not specific for immune complex-mediated glomerulonephritis.
**Option D:** Albumin is a major protein that is filtered through the glomeruli, but its presence is not specific for immune complex-mediated glomerulonephritis.
**Clinical Pearl / High-Yield Fact**
Post-streptococcal glomerulonephritis often follows a streptococcal infection by 1-3 weeks, and the presence of IgG or IgM antibodies to streptococcal antigens in the serum can support this diagnosis.
**Correct Answer:** D. IgG or IgM.
Free Medical MCQs Β· NEET PG Β· USMLE Β· AIIMS
Access thousands of free MCQs, ebooks and daily exams.
By signing in you agree to our Privacy Policy.