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USMLE 2CK Practice Question for December 2nd

A 32-year-old woman comes to the physician because of swelling in her face, hands, and feet that has been increasing over the past week. She has never experienced anything like this before. She has no other symptoms and takes no medications. Her temperature is 37.1°C (98.8°F), pulse is 86/min, respirations are 16/min, and blood pressure is 140/88 mm Hg. Physical examination shows a multiple painless ulcers on the buccal mucosa. There is a mildly erythematous rash over the cheeks and the bridge of the nose. The joints of the hands are notably tender. There is non-pitting edema around her eyes and in her hands and feet. Urinalysis shows 3+ protein, and a 24-hour urine study shows 3.4 g of protein. Tests for anti-double stranded DNA antibodies and complement levels have been ordered. What is the most likely finding on renal biopsy?

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