**Core Concept**
Alport syndrome is a genetic disorder characterized by glomerulonephritis, end-stage kidney disease, and hearing loss. It is caused by mutations in the COL4A3, COL4A4, or COL4A5 genes, which encode type IV collagen proteins. This condition is primarily inherited in an X-linked dominant pattern.

**Why the Correct Answer is Right**
The correct answer is C. X-linked dominant because the COL4A5 gene, responsible for Alport syndrome, is located on the X chromosome. Females, who have two X chromosomes, are usually carriers and can exhibit mild symptoms, while males, with only one X chromosome, are more severely affected due to their lack of a second X chromosome to compensate for the mutated gene. This X-linked dominant pattern of inheritance is a result of the inactivation of one X chromosome in females (X-inactivation), leading to the expression of the mutated gene in a subset of their cells.

**Why Each Wrong Option is Incorrect**
**Option A:** Autosomal dominant is incorrect because Alport syndrome is primarily associated with the X chromosome, not an autosomal chromosome. Autosomal dominant inheritance would imply equal expression of the mutated gene in both males and females, which is not the case for Alport syndrome.

**Option B:** Autosomal recessive is incorrect because Alport syndrome is not caused by mutations in autosomal chromosomes. While females can be carriers, they do not exhibit the same severity of symptoms as males, and their inheritance pattern does not follow an autosomal recessive pattern.

**Option D:** X-linked recessive is incorrect because Alport syndrome is not inherited in an X-linked recessive pattern. Females can be carriers and exhibit mild symptoms, which is not characteristic of X-linked recessive conditions, where males are typically more severely affected.

**Clinical Pearl / High-Yield Fact**
It's essential to remember that X-linked dominant conditions, such as Alport syndrome, can exhibit variable expression in females due to X-inactivation. This can lead to a range of symptoms, from mild to severe, in affected females.

**✓ Correct Answer: C. X linked dominant**