This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiration, Subject name: Pathology
A 29-year-old man who has had no major illnesses experiences acute onset of hemoptysis. On physical examination, he has a temperature of 37deg C, pulse of 83/min, respirations of 28/min, and blood pressure of 150/95 mm Hg. A chest radiograph shows bilateral fluffy infiltrates. A transbronchial lung biopsy on microscopic examination shows focal necrosis of alveolar walls associated with prominent intra-alveolar hemorrhage. Two days later, he has oliguria. The serum creatinine level is 2.9 mg/dL, and urea nitrogen is 31 mg/dL. Which of the following antibodies is most likely involved in the pathogenesis of his condition? 
Select and explain. 
A. Anti-DNA topoisomerase I antibody, B. Anti-glomerular basement membrane antibody, C. Antimitochondrial antibody, D. Anti-neutrophil cytoplasmic antibody
B: Anti-glomerular basement membrane antibody
Answer: B: Anti-glomerular basement membrane antibody 
Explanation: Goodpasture syndrome leads to renal and pulmonary lesions produced by an antibody directed against an antigen common to the basement membrane in glomerulus and alveolus. This leads to a type II hypersensitivity reaction. The anti-DNA topoisomerase I antibody is a marker for scleroderma. Antimitochondrial antibody is associated with primary biliary cirrhosis. C-ANCA and P-ANCA are best known as markers for various forms of systemic vasculitis. ANA is used as a general screening test for various autoimmune conditions, typically collagen vascular diseases such as systemic lupus erythematosus.