<prompt> A 25 years old female develops serous otitis media of left ear with cough and occasional hemoptysis and hematuria and epistaxis for one and half months her. Hemoglobin is 7 gm. B.P. 170100, proteinuria , RA positive ve and ANCA positive ve, the likely cause is:Wegeners granulomatosisRheumatoid arthritisRapidly proliferative glomerulonephritisGood Pasteurs syndrome  <response>: Ans. A. Wegeners granulomatosisa. Any vasculitic lesion involving upper respiratory tract, lungs kidney is characteristic of Wegnersb. In this case, serous otitis media with hemoptysis, hematuria with C-ANCA positive is diagnostic of Wegners 