skip to main content

Rapidly progressive glomerulonephritis — RCPSC IM MCQ

Instant feedback + full explanation. One question, done properly.

HardNephrologyRapidly progressive glomerulonephritisRCPSC IM

A 42-year-old has hemoptysis, rapidly rising creatinine, red-cell casts and diffuse alveolar hemorrhage. PR3-ANCA is positive. What is the best next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Obtain kidney biopsy and begin ANCA-vasculitis induction planning

The best answer is “Obtain kidney biopsy and begin ANCA-vasculitis induction planning”. This is pulmonary-renal syndrome with organ-threatening ANCA-associated vasculitis. Kidney biopsy provides diagnostic and prognostic information, but treatment planning is urgent and should not await serial titres when life-threatening disease is present. Life-threatening pulmonary haemorrhage and rapidly progressive kidney injury justify parallel stabilization, diagnostic confirmation and specialist treatment planning rather than a slow serial approach.

Reference: KDIGO, 2024 CKD guideline: https://kdigo.org/guidelines/ckd-evaluation-and-management/