KROK 1 2019 – Question 166 · KROK (Medicine) · Pathophysiology
A 38-year-old woman, who was diagnosed with systemic lupus erythematosus (SLE) 3 years ago, comes to her physician with a complaint of facial swelling and decreased urination that she first noticed 2 weeks ago. She currently takes azathioprine and corticosteroid. Her vital signs show blood pressure 150/90 mm Hg, pulse - 91/min., temperature - 36.8°C and respiratory rate - 15/min. On physical examination, the doctor notices erythematous rash on her face exhibiting a butterfly pattern. The laboratory studies reveal hypercholesterolemia, hypertriglyceridemia and proteinuria. Which of the following is the most likely mechanism of SLE’s complication in this patient?
- A. Acute infection of the kidney
- B. Decrease in renal blood flow (ischemic nephropathy)
- C. Immune complex-mediated glomerular disease
- D. Increased plasma oncotic pressure
- E. -
Hint
Think about the immunological mechanism by which lupus injures tissue and which part of the kidney's filtering apparatus it damages, given heavy protein loss with edema and hypertension.
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