A 64-Year-Old Man Comes to the Office Due to Generalized

A 64-year-old man comes to the office due to generalized edema, fatigue, and dyspnea on exertion for 2 months.  The patient has a 25-year history of poorly controlled rheumatoid arthritis.  Temperature is 36.9 C (98.4 F) , blood pressure is 108/70 mm Hg, and pulse is 90/min.  The patient is thin and appears chronically ill but is in no acute distress.  There is no lymphadenopathy.  Breath sounds are decreased at the lung bases.  Musculoskeletal examination shows severe deformities of the hands and feet related to rheumatoid arthritis.  There is pitting edema of both legs up to the knees.  Peripheral pulses are normal.  Urinalysis shows 4+ protein but is otherwise normal.  A renal biopsy is performed.  Which of the following histologic abnormalities is most likely to be seen in this patient's glomeruli?

A) Crescent formation
B) Deposition of amorphous material
C) Diffuse hypercellularity
D) IgA deposition
E) No abnormalities

Correct Answer:

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