Endocrine: aldosterone escape: 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 · Endocrine: aldosterone escape

Sample item

A man with an aldosterone-secreting adenoma has hypertension and hypokalaemia but no peripheral oedema. What explains the absence of oedema?

APressure natriuresis and raised atrial natriuretic peptide overcome sodium retention after volume expansionBIncreased plasma oncotic pressure moves fluid into capillariesCAldosterone does not retain sodium in the collecting ductDAldosterone causes potassium retention rather than sodium retention

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

The answer and the reasoning

A. Pressure natriuresis and raised atrial natriuretic peptide overcome sodium retention after volume expansion

Aldosterone initially retains sodium and expands extracellular volume by a modest amount. The rise in arterial pressure and ANP then increase sodium excretion in other segments, so sodium balance is restored (aldosterone escape). Volume stays only mildly raised and oedema does not occur.

Option by option

A. Pressure natriuresis and raised atrial natriuretic peptide overcome sodium retention after volume expansion (correct)
Correct. Pressure natriuresis and ANP stop the further sodium and water accumulation.
B. Increased plasma oncotic pressure moves fluid into capillaries
Oncotic pressure does not rise in this condition.
C. Aldosterone does not retain sodium in the collecting duct
Aldosterone does retain sodium through ENaC in the principal cells.
D. Aldosterone causes potassium retention rather than sodium retention
Aldosterone promotes potassium excretion, causing hypokalaemia.

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.

Questions about this Physiology question

What is the answer to this Physiology question?

The best answer is A, Pressure natriuresis and raised atrial natriuretic peptide overcome sodium retention after volume expansion. Aldosterone initially retains sodium and expands extracellular volume by a modest amount.

Why is "Increased plasma oncotic pressure moves fluid into capillaries" not the answer?

Oncotic pressure does not rise in this condition.

Why is "Aldosterone does not retain sodium in the collecting duct" not the answer?

Aldosterone does retain sodium through ENaC in the principal cells.

Why is "Aldosterone causes potassium retention rather than sodium retention" not the answer?

Aldosterone promotes potassium excretion, causing hypokalaemia.

What concept does this question test?

It tests Endocrine: aldosterone escape in Physiology. The rise in arterial pressure and ANP then increase sodium excretion in other segments, so sodium balance is restored (aldosterone escape). Volume stays only mildly raised and oedema does not occur.

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 Endocrine: aldosterone escape?

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.