question: Q:A previously healthy 48-year-old man comes to the physician for a 3-month history of myalgias and recurrent episodes of retrosternal chest pain and dizziness. He has had a 5-kg (11-lb) weight loss during this period. His temperature is 39.1°C (102.3°F), pulse is 90/min, and blood pressure is 160/102 mm Hg. Physical examination shows lacy, purplish discoloration of the skin with multiple erythematous, tender subcutaneous nodules on the lower legs. Some of the nodules have central ulcerations. Serum studies show an erythrocyte sedimentation rate of 76 mg/dL and creatinine level of 1.8 mg/dL. Renal MR angiography shows irregular areas of dilation and constriction in the renal arteries bilaterally. Further evaluation of this patient is most likely to show which of the following?? 
  {'A': 'Multinuclear giant cells with elastic membrane fragmentation on arterial biopsy', 'B': 'Transmural inflammation with fibrinoid necrosis on arterial biopsy', 'C': 'Pulmonary artery microaneurysms on pulmonary angiography', 'D': 'Presence of anti-myeloperoxidase antibodies in the serum', 'E': 'Presence of anti-proteinase 3 antibodies in the serum'},