This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
30-yr-male have hemoptysis, facial puffiness, microscopic hematuria & increased serum creatinine. What should be included in the investigation: 
Select and explain. 
A. X-ray chest, B. ANA, C. ANCA, D. CT scan
B: ANA
Answer: B: ANA 
Explanation: This patient have -facial puffiness and hemoptysis microscopic hematuria & increased serum creatinine
The possible aetiology includes:

Good pasture syndrome
Vasculis Q (Wegener’s granulomatosis, CSS, Microscopic ployangis)
SLE'
Cryoglobulinemia

Investigation; To be recommended

Chest X-ray or CT scan Chest should be done for any cavitary lesions or infiltrates.
ANCA should be advised for Wegener's granulomatosis, MPA, CSS (Charge Strauss syndrome).
24-hour urinary protein should he done to document Glomerular proteinuria
ANA for SLE