Nephrology: practice question

A Pediatrics 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

Pediatrics · Nephrology

Sample item

A male newborn has a poor urinary stream, a palpable bladder and bilateral hydronephrosis on antenatal scan, and has had oligohydramnios. After stabilisation, which investigation will confirm the diagnosis, and what is the first step in management?

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

The answer and the reasoning

C. Voiding cystourethrogram showing a dilated posterior urethra; bladder catheterisation

Posterior urethral valves are the commonest cause of bladder outlet obstruction in boys. Oligohydramnios causes pulmonary hypoplasia, and obstruction causes bilateral hydroureteronephrosis and renal impairment. Immediate catheter drainage relieves obstruction, and a VCUG demonstrates a dilated, elongated posterior urethra before endoscopic valve ablation.

Option by option

  • A. DMSA scan; antibiotics alone

    DMSA assesses scarring and antibiotics alone do not relieve obstruction.

  • B. Intravenous urography; immediate nephrectomy

    Nephrectomy is not indicated and intravenous urography is not the preferred study in a newborn.

  • C. Voiding cystourethrogram showing a dilated posterior urethra; bladder catheterisation (correct)

    Correct. Catheter drainage relieves pressure and VCUG shows the valve level dilatation.

  • D. Renal biopsy; steroids

    Biopsy and steroids have no role in obstruction.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Voiding cystourethrogram showing a dilated posterior urethra; bladder catheterisation. Posterior urethral valves are the commonest cause of bladder outlet obstruction in boys.

Why is "DMSA scan; antibiotics alone" not the answer?

DMSA assesses scarring and antibiotics alone do not relieve obstruction.

Why is "Intravenous urography; immediate nephrectomy" not the answer?

Nephrectomy is not indicated and intravenous urography is not the preferred study in a newborn.

Why is "Renal biopsy; steroids" not the answer?

Biopsy and steroids have no role in obstruction.

What concept does this question test?

It tests Nephrology in Pediatrics. Oligohydramnios causes pulmonary hypoplasia, and obstruction causes bilateral hydroureteronephrosis and renal impairment. Immediate catheter drainage relieves obstruction, and a VCUG demonstrates a dilated, elongated posterior urethra before endoscopic valve ablation.

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?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.