Abdomen: left renal vein: practice question

A Anatomy 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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Anatomy · Abdomen: left renal vein

Sample item

A tall, thin 22-year-old woman has recurrent left flank pain and painless macroscopic haematuria. Doppler shows a dilated left renal vein proximal to the point where it crosses the aorta, with a narrowed segment at the crossing. Which structure is compressing the vein?

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

The answer and the reasoning

C. Superior mesenteric artery

The left renal vein passes between the aorta behind and the superior mesenteric artery in front. In a thin patient with a narrow aortomesenteric angle the vein is compressed (nutcracker syndrome), raising venous pressure and causing haematuria from rupture of thin-walled calyceal veins. It can also cause left varicocele and pelvic congestion.

Option by option

  • A. Inferior mesenteric artery

    The inferior mesenteric artery arises lower and does not cross the left renal vein.

  • B. Splenic artery

    The splenic artery runs along the upper border of the pancreas, above the level of the vein.

  • C. Superior mesenteric artery (correct)

    Correct. The vein is squeezed between the SMA and the aorta.

  • D. Coeliac trunk

    The coeliac trunk arises above the left renal vein and does not lie anterior to it.

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 Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is C, Superior mesenteric artery. The left renal vein passes between the aorta behind and the superior mesenteric artery in front.

Why is "Inferior mesenteric artery" not the answer?

The inferior mesenteric artery arises lower and does not cross the left renal vein.

Why is "Splenic artery" not the answer?

The splenic artery runs along the upper border of the pancreas, above the level of the vein.

Why is "Coeliac trunk" not the answer?

The coeliac trunk arises above the left renal vein and does not lie anterior to it.

What concept does this question test?

It tests Abdomen: left renal vein in Anatomy. In a thin patient with a narrow aortomesenteric angle the vein is compressed (nutcracker syndrome), raising venous pressure and causing haematuria from rupture of thin-walled calyceal veins. It can also cause left varicocele and pelvic congestion.

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 Abdomen: left renal vein?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy 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.