# A nurse is assessing a 28-year-old male client who was admitted with suspected Goodpasture's syndrome. Which assessment finding would be most characteristic of this condition? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=540853 > language: ko > subject: Adult Health ## 문제 A nurse is assessing a 28-year-old male client who was admitted with suspected Goodpasture's syndrome. Which assessment finding would be most characteristic of this condition? ## 보기 1. Butterfly rash across the face and photosensitivity 2. Joint pain and morning stiffness lasting more than one hour 3. Dry eyes and mouth with difficulty swallowing 4. Hemoptysis and hematuria occurring simultaneously **✔ 정답** **정답: 4** ## 해설 Goodpasture's syndrome is characterized by simultaneous hemoptysis and hematuria due to anti-GBM antibodies attacking lungs and kidneys. Other options are typical of other autoimmune diseases like SLE (butterfly rash), rheumatoid arthritis (joint pain), or Sjögren's syndrome (dry eyes/mouth). ## 심화 해설 Understanding Goodpasture's Syndrome Goodpasture's syndrome, also known as anti-glomerular basement membrane (anti-GBM) disease, is a rare but life-threatening autoimmune condition. In this disorder, the immune system mistakenly creates antibodies that attack a specific protein (type IV collagen) found in the basement membranes of the kidneys and lungs [1]. This simultaneous attack leads to a classic combination of symptoms that is highly characteristic of the disease. Why Hemoptysis and Hematuria Occur Together The pathophysiology directly explains why option 4 is the most characteristic finding. The autoantibodies target the glomerular basement membrane in the kidneys, causing rapidly progressive glomerulonephritis. This damage allows red blood cells to leak into the urine, resulting in hematuria [1,3]. At the same time, these antibodies attack the alveolar basement membrane in the lungs, leading to pulmonary hemorrhage or bleeding into the lung tissue. This manifests as hemoptysis (coughing up blood) [1,2]. This concurrent lung and kidney bleeding is the hallmark pulmonary-renal syndrome that defines Goodpasture's [3]. The condition can rapidly progress to acute kidney injury and respiratory failure, as noted in multiple case studies [1,4]. Analyzing the Incorrect Options The other options describe distinct autoimmune conditions with different underlying mechanisms, making them incorrect in this context. - Option 1: A butterfly rash and photosensitivity are classic signs of systemic lupus erythematosus (SLE), a different autoimmune disease that can also cause nephritis but is not defined by anti-GBM antibodies. - Option 2: Joint pain and prolonged morning stiffness are hallmarks of rheumatoid arthritis, an inflammatory condition primarily targeting the synovium of joints. - Option 3: The combination of dry eyes (keratoconjunctivitis sicca) and dry mouth (xerostomia) with difficulty swallowing is characteristic of Sjögren's syndrome, an autoimmune attack on moisture-producing glands. Key Clinical Presentation and Diagnostic Clues When assessing a patient with suspected Goodpasture's syndrome, the nurse should look for this specific pulmonary-renal pattern. A patient may present with dyspnea, cough, and hemoptysis alongside signs of acute kidney injury, such as decreased urine output and hematuria [3,4]. Laboratory findings would typically show a rapid rise in serum creatinine and severe anemia. While serological testing for anti-GBM antibodies is a key diagnostic tool, it is critical to know that a rare seronegative form exists where the antibody test is negative, but the disease is still present and can be confirmed by kidney or lung biopsy [4]. The condition can be triggered by environmental factors like smoking or hydrocarbon exposure, but it can also occur without them, as seen in a case following radiation therapy [1,4].References (research sources) - [1]Goodpasture's Syndrome Following Radiation Exposure: A Rare Pulmonary-Renal Complication.Research articleDjoo S, Seuylemezian L, Mellott A, Kim NM, Singh J. (2026) · DOI: 10.7759/cureus.107499 - [3]Anti-GBM pulmonary-renal syndrome: when the laboratory makes the difference.Research articleFrías Ruiz C, Martín Martínez MD. (2026) · DOI: 10.1515/almed-2025-0099 - [4]A Rare Case of Seronegative anti-Glomerular Basement Membrane Disease with Pulmonary Involvement.Research articleDoak W, Baptiste T, Chang A, Kerns ES, Lynch MR. (2026) ## 임상 시나리오 Goodpasture Syndrome: Key AssessmentRecognizing the Pulmonary-Renal Hallmark Goodpasture syndrome is a life-threatening autoimmune disorder where anti-GBM antibodies attack type IV collagen in the lungs and kidneys. The most characteristic presentation is simultaneous hemoptysis (pulmonary hemorrhage) and hematuria (glomerulonephritis), termed a pulmonary-renal syndrome. CautionThis condition can rapidly progress to acute kidney injury and respiratory failure. Early recognition and prompt plasmapheresis are critical to prevent permanent organ damage. ## 핵심 개념 - **Goodpasture's syndrome** — A rare autoimmune disease where antibodies attack type IV collagen in the basement membranes of lung alveoli and kidney glomeruli, causing pulmonary hemorrhage and rapidly progressive glomerulonephritis. - **Pulmonary-renal syndrome** — A clinical syndrome involving diffuse alveolar hemorrhage and glomerulonephritis; Goodpasture's syndrome is a classic cause. - **Anti-GBM antibodies** — Autoantibodies directed against the glomerular basement membrane, the hallmark serologic finding in Goodpasture's disease. - **Crescentic glomerulonephritis** — A histopathologic pattern of severe glomerular injury characterized by crescent-shaped cell proliferation in Bowman's space, often seen in Goodpasture's syndrome. - **Linear IgG deposition** — The diagnostic immunofluorescence pattern seen on kidney biopsy in Goodpasture's syndrome, showing a smooth, linear staining of IgG along the GBM. ## 같은 주제 문제 - [A nurse is assessing a 28-year-old male patient admitted with suspected Goodpasture's synd…](https://mymerci.kr/pages/nclex_q.php?qn_id=540854) - [A nurse is caring for a client with Goodpasture's syndrome who is experiencing hemoptysis …](https://mymerci.kr/pages/nclex_q.php?qn_id=540855) - [A nurse is caring for a patient with Goodpasture's syndrome who is experiencing progressiv…](https://mymerci.kr/pages/nclex_q.php?qn_id=540856) - [A nurse is caring for a patient with Goodpasture's syndrome who is experiencing progressiv…](https://mymerci.kr/pages/nclex_q.php?qn_id=540857) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._