Haemodynamics: lymphatic oedema: practice question

A Pathology 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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Pathology · Haemodynamics: lymphatic oedema

Sample item

A 40-year-old man from coastal Odisha has had chronic swelling of the right leg for 6 years. The skin is thickened and rough, and pressing leaves no pit. Which mechanism is primarily responsible?

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

The answer and the reasoning

C. Lymphatic obstruction by adult filarial worms, causing protein-rich interstitial fluid accumulation and fibrosis

Lymphoedema results from impaired lymph drainage, so protein-rich fluid accumulates and chronic inflammation causes fibrosis and brawny, non-pitting induration. In India this is classically due to Wuchereria bancrofti, with obstruction by adult worms and repeated secondary infections. Elephantiasis is the end result.

Option by option

  • A. Raised hydrostatic pressure from incompetent deep venous valves

    Venous valve incompetence causes pitting oedema and pigmentation or ulceration of the gaiter area.

  • B. Sodium and water retention from secondary hyperaldosteronism in heart failure

    Hyperaldosteronism in heart failure causes bilateral pitting oedema with raised jugular venous pressure.

  • C. Lymphatic obstruction by adult filarial worms, causing protein-rich interstitial fluid accumulation and fibrosis (correct)

    Correct. Lymphatic obstruction causes non-pitting, protein-rich oedema with fibrosis.

  • D. Reduced plasma oncotic pressure from protein loss in urine

    Hypoalbuminaemia, as in nephrotic syndrome, causes generalised soft pitting oedema.

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 Pathology question

What is the answer to this Pathology question?

The best answer is C, Lymphatic obstruction by adult filarial worms, causing protein-rich interstitial fluid accumulation and fibrosis. Lymphoedema results from impaired lymph drainage, so protein-rich fluid accumulates and chronic inflammation causes fibrosis and brawny, non-pitting induration.

Why is "Raised hydrostatic pressure from incompetent deep venous valves" not the answer?

Venous valve incompetence causes pitting oedema and pigmentation or ulceration of the gaiter area.

Why is "Sodium and water retention from secondary hyperaldosteronism in heart…" not the answer?

Hyperaldosteronism in heart failure causes bilateral pitting oedema with raised jugular venous pressure.

Why is "Reduced plasma oncotic pressure from protein loss in urine" not the answer?

Hypoalbuminaemia, as in nephrotic syndrome, causes generalised soft pitting oedema.

What concept does this question test?

It tests Haemodynamics: lymphatic oedema in Pathology. In India this is classically due to Wuchereria bancrofti, with obstruction by adult worms and repeated secondary infections. Elephantiasis is the end result.

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 Haemodynamics: lymphatic oedema?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.