Haemodynamics: renal contribution to cardiac 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: renal contribution to cardiac oedema

Sample item

A man with chronic right heart failure has pitting leg oedema that worsens despite normal albumin. Which process in the kidney most directly sustains the generalised oedema?

AReduced renal perfusion activating renin-angiotensin-aldosterone and retaining sodiumBMassive protein loss across the glomerular filterCObstruction of lymph drainage by fibrosis of the nodesDPrimary increase in capillary permeability from endothelial injury

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

The answer and the reasoning

A. Reduced renal perfusion activating renin-angiotensin-aldosterone and retaining sodium

Low effective arterial volume in heart failure reduces renal perfusion, activating RAAS and ADH. Sodium and water retention raises plasma volume and further increases capillary hydrostatic pressure, perpetuating oedema.

Option by option

A. Reduced renal perfusion activating renin-angiotensin-aldosterone and retaining sodium (correct)
Correct. Sodium and water retention through RAAS adds to the raised venous pressure.
B. Massive protein loss across the glomerular filter
Protein loss through the glomerulus is nephrotic syndrome, with a low albumin.
C. Obstruction of lymph drainage by fibrosis of the nodes
Lymphatic obstruction causes localised non-pitting oedema, not generalised oedema.
D. Primary increase in capillary permeability from endothelial injury
Permeability oedema follows inflammation or burns, not simple cardiac failure.

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 Pathology question

What is the answer to this Pathology question?

The best answer is A, Reduced renal perfusion activating renin-angiotensin-aldosterone and retaining sodium. Low effective arterial volume in heart failure reduces renal perfusion, activating RAAS and ADH.

Why is "Massive protein loss across the glomerular filter" not the answer?

Protein loss through the glomerulus is nephrotic syndrome, with a low albumin.

Why is "Obstruction of lymph drainage by fibrosis of the nodes" not the answer?

Lymphatic obstruction causes localised non-pitting oedema, not generalised oedema.

Why is "Primary increase in capillary permeability from endothelial injury" not the answer?

Permeability oedema follows inflammation or burns, not simple cardiac failure.

What concept does this question test?

It tests Haemodynamics: renal contribution to cardiac oedema in Pathology. Sodium and water retention raises plasma volume and further increases capillary hydrostatic pressure, perpetuating oedema.

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: renal contribution to cardiac 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.