Nephrology: acute kidney injury: 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.

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General Medicine · Nephrology: acute kidney injury

Sample item

A patient with vomiting and diarrhea has oliguria, concentrated urine, and a fractional excretion of sodium below 1%. Which mechanism of acute kidney injury is most likely?

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

The answer and the reasoning

D. Prerenal hypoperfusion

With intact renal tubules, volume depletion causes sodium and water retention, often giving a low fractional excretion of sodium. This supports prerenal hypoperfusion when interpreted with the clinical picture.

Option by option

  • A. Postrenal obstruction

    Postrenal obstruction requires consideration of urinary tract blockage and imaging when appropriate.

  • B. Acute tubular necrosis

    Acute tubular necrosis often impairs sodium reabsorption and tends to have a higher fractional sodium excretion.

  • C. Rapidly progressive glomerulonephritis

    Rapidly progressive glomerulonephritis commonly causes an active urinary sediment with hematuria and casts.

  • D. Prerenal hypoperfusion (correct)

    Correct. Gastrointestinal fluid loss with avid sodium retention suggests prerenal AKI.

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.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Prerenal hypoperfusion. With intact renal tubules, volume depletion causes sodium and water retention, often giving a low fractional excretion of sodium.

Why is "Postrenal obstruction" not the answer?

Postrenal obstruction requires consideration of urinary tract blockage and imaging when appropriate.

Why is "Acute tubular necrosis" not the answer?

Acute tubular necrosis often impairs sodium reabsorption and tends to have a higher fractional sodium excretion.

Why is "Rapidly progressive glomerulonephritis" not the answer?

Rapidly progressive glomerulonephritis commonly causes an active urinary sediment with hematuria and casts.

What concept does this question test?

It tests Nephrology: acute kidney injury in General Medicine. This supports prerenal hypoperfusion when interpreted with the clinical picture.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Nephrology: acute kidney injury?

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.