Renal physiology: Starling forces: practice question

A Physiology 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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Physiology · Renal physiology: Starling forces

Sample item

A patient with nephrotic syndrome develops generalised oedema. Which Starling force change is the principal explanation?

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

The answer and the reasoning

D. Reduced plasma oncotic pressure

Heavy proteinuria lowers plasma albumin and so plasma oncotic pressure. Fluid then leaves capillaries and accumulates in the interstitium, supplemented by secondary sodium retention. Capillary hydrostatic pressure is not reduced in this condition.

Option by option

  • A. Reduced capillary permeability

    Permeability is not reduced, and increased permeability is the problem in inflammation.

  • B. Reduced capillary hydrostatic pressure

    Hydrostatic pressure falls with hypovolaemia but would not itself cause oedema.

  • C. Increased interstitial oncotic pressure

    The interstitial oncotic pressure is not raised.

  • D. Reduced plasma oncotic pressure (correct)

    Correct. A low oncotic pressure favours filtration out of capillaries.

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 Physiology question

What is the answer to this Physiology question?

The best answer is D, Reduced plasma oncotic pressure. Heavy proteinuria lowers plasma albumin and so plasma oncotic pressure.

Why is "Reduced capillary permeability" not the answer?

Permeability is not reduced, and increased permeability is the problem in inflammation.

Why is "Reduced capillary hydrostatic pressure" not the answer?

Hydrostatic pressure falls with hypovolaemia but would not itself cause oedema.

Why is "Increased interstitial oncotic pressure" not the answer?

The interstitial oncotic pressure is not raised.

What concept does this question test?

It tests Renal physiology: Starling forces in Physiology. Fluid then leaves capillaries and accumulates in the interstitium, supplemented by secondary sodium retention. Capillary hydrostatic pressure is not reduced in this condition.

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 physiology: Starling forces?

For each system, sketch the key graph (pressure–volume loop, oxygen dissociation curve, nephron handling) and explain it aloud. Then use the flashcards and the other Physiology 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.