Renal medicine: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Renal medicine

Sample item

Which finding most suggests a pre-renal cause of acute kidney injury in a patient with vomiting?

AHeavy proteinuria with red-cell castsBPainless gross haematuria from a stoneCHistory of volume loss and low blood pressureDLongstanding small echogenic kidneys

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. History of volume loss and low blood pressure

Vomiting can cause intravascular volume depletion and reduced renal perfusion, producing pre-renal acute kidney injury that may improve after appropriate fluid replacement and treatment of the cause.

Option by option

A. Heavy proteinuria with red-cell casts
Red-cell casts suggest glomerular inflammation rather than a pre-renal state.
B. Painless gross haematuria from a stone
A stone may obstruct urine flow rather than causing a pre-renal insult.
C. History of volume loss and low blood pressure (correct)
Correct: hypovolaemia and hypotension reduce kidney perfusion.
D. Longstanding small echogenic kidneys
Small chronic kidneys suggest established chronic kidney disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, History of volume loss and low blood pressure. Vomiting can cause intravascular volume depletion and reduced renal perfusion, producing pre-renal acute kidney injury that may improve after appropriate fluid replacement and treatment of the cause.

Why is "Heavy proteinuria with red-cell casts" not the answer?

Red-cell casts suggest glomerular inflammation rather than a pre-renal state.

Why is "Painless gross haematuria from a stone" not the answer?

A stone may obstruct urine flow rather than causing a pre-renal insult.

Why is "Longstanding small echogenic kidneys" not the answer?

Small chronic kidneys suggest established chronic kidney disease.

What concept does this question test?

It tests Renal medicine in General Medicine. The correct option holds because: Correct: hypovolaemia and hypotension reduce kidney perfusion.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Renal medicine?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.