Okay, let's tackle this question. The patient is a 14-year-old boy with hemoptysis, hematuria, proteinuria, hypertension, anemia, and a low hematocrit. The key symptoms here are the blood in sputum and urine, plus the lab findings. The probable diagnosis is likely a vasculitis or a systemic disease affecting the kidneys and lungs.

First, the core concept here is Goodpasture's syndrome, which is an autoimmune condition where antibodies target the basement membrane of the lungs and kidneys. This leads to glomerulonephritis and pulmonary hemorrhage. The presence of both hemoptysis and hematuria points towards this. Also, the anemia could be due to chronic disease or blood loss from the pulmonary bleeding.

The correct answer would be Goodpasture's syndrome because the clinical triad of hemoptysis, hematuria, and pulmonary-renal syndrome fits. The presence of anti-GBM antibodies confirms the diagnosis, but the question doesn't mention the antibodies, so we rely on the presentation.

Now, looking at the other options. Option A could be Wegener's granulomatosis (now GPA), which affects upper and lower respiratory tracts and kidneys, but it's typically ANCA-positive and presents with granulomas, which isn't mentioned here. Option B might be Henoch-Schönlein purpura, which is IgA-mediated and more common in children but presents with palpable purpura, not hemoptysis. Option C could be systemic lupus erythematosus (SLE), which can cause lupus nephritis and other symptoms, but the hemoptysis is less characteristic. Option D might be IgA nephropathy, which is more about hematuria after infections, not hemoptysis.

The clinical pearl here is to remember the classic triad of Goodpasture's syndrome. Also, the presence of both pulmonary and renal symptoms with anemia and hypertension is a red flag for this condition. The high-yield fact is that anti-GBM antibodies are diagnostic, but the question doesn't provide that info, so the presentation is the key.

**Core Concept:** The clinical scenario describes a 14-year-old with pulmonary hemorrhage (hemoptysis), glomerulonephritis (hematuria, proteinuria), and anemia, pointing to a systemic vasculitis or immune-mediated disease. The combination of **pulmonary-renal syndrome** with anti-glomerular basement membrane (anti-GBM) antibody production is pathognomonic for **Goodpasture syndrome**.

**Why the Correct Answer is Right:**
Goodpasture syndrome is an autoimmune disorder where autoantibodies target type IV collagen in basement membranes of the glomeruli (causing glomerulonephritis) and alveoli (causing pulmonary hemorrhage). The patient’s hemoptysis (lung involvement), hematuria/proteinuria (kidney involvement), and anemia (chronic blood loss) align with this diagnosis. Hypertension may arise from renal dysfunction. Confirmatory testing would detect anti-GBM antibodies, but the clinical triad is diagnostic in context.

**Why Each Wrong Option is Incorrect:**
**Option A (Wegener’s granulomatosis, now GPA):** Presents with granulomatous inflammation in upper/lower airways and kidneys, but

✓ Correct Answer: A. Goodpasture syndrome