Renal pathology: anti-GBM disease: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Renal pathology: anti-GBM disease

Sample item

A 24-year-old smoker has haemoptysis and rapidly progressive renal failure. Renal biopsy immunofluorescence shows smooth, linear IgG staining along the glomerular basement membrane. The antibodies target:

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. The alpha-3 chain of type IV collagen

Goodpasture (anti-GBM) disease involves autoantibodies against the non-collagenous domain of the alpha-3 chain of type IV collagen in glomerular and alveolar basement membranes. It causes crescentic glomerulonephritis with pulmonary haemorrhage. Treatment is plasma exchange, steroids and cyclophosphamide.

Option by option

  • A. Double-stranded DNA

    Anti-dsDNA is seen in lupus nephritis with granular immune-complex deposits.

  • B. Phospholipase A2 receptor

    Anti-phospholipase A2 receptor antibodies are found in primary membranous nephropathy with granular deposits.

  • C. The alpha-3 chain of type IV collagen (correct)

    Correct. Linear IgG deposition reflects antibody binding to basement membrane type IV collagen.

  • D. Proteinase 3

    Proteinase 3 is the target of c-ANCA in granulomatosis with polyangiitis, which is pauci-immune.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, The alpha-3 chain of type IV collagen. Goodpasture (anti-GBM) disease involves autoantibodies against the non-collagenous domain of the alpha-3 chain of type IV collagen in glomerular and alveolar basement membranes.

Why is "Double-stranded DNA" not the answer?

Anti-dsDNA is seen in lupus nephritis with granular immune-complex deposits.

Why is "Phospholipase A2 receptor" not the answer?

Anti-phospholipase A2 receptor antibodies are found in primary membranous nephropathy with granular deposits.

Why is "Proteinase 3" not the answer?

Proteinase 3 is the target of c-ANCA in granulomatosis with polyangiitis, which is pauci-immune.

What concept does this question test?

It tests Renal pathology: anti-GBM disease in Pathology. It causes crescentic glomerulonephritis with pulmonary haemorrhage. Treatment is plasma exchange, steroids and cyclophosphamide.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Renal pathology: anti-GBM disease?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.