Reproduction: renal changes in pregnancy: 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 · Reproduction: renal changes in pregnancy

Sample item

A pregnant woman at 24 weeks has serum creatinine 0.5 mg/dL, lower than the usual adult range. Why?

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

The answer and the reasoning

D. Increased GFR from raised renal plasma flow clears creatinine faster

Renal plasma flow and GFR rise considerably in pregnancy, so creatinine and urea are cleared faster and serum levels fall. A creatinine that would be normal outside pregnancy may therefore signal impaired function.

Option by option

  • A. Increased tubular secretion of creatinine

    Tubular secretion of creatinine is not the main change in pregnancy.

  • B. Reduced muscle mass during pregnancy

    Muscle mass does not fall in pregnancy.

  • C. Dilution of creatinine in the fetal circulation

    The fetal circulation does not act as a sink that dilutes maternal creatinine.

  • D. Increased GFR from raised renal plasma flow clears creatinine faster (correct)

    Correct. Hyperfiltration lowers serum creatinine.

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, Increased GFR from raised renal plasma flow clears creatinine faster. Renal plasma flow and GFR rise considerably in pregnancy, so creatinine and urea are cleared faster and serum levels fall.

Why is "Increased tubular secretion of creatinine" not the answer?

Tubular secretion of creatinine is not the main change in pregnancy.

Why is "Reduced muscle mass during pregnancy" not the answer?

Muscle mass does not fall in pregnancy.

Why is "Dilution of creatinine in the fetal circulation" not the answer?

The fetal circulation does not act as a sink that dilutes maternal creatinine.

What concept does this question test?

It tests Reproduction: renal changes in pregnancy in Physiology. A creatinine that would be normal outside pregnancy may therefore signal impaired function.

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 Reproduction: renal changes in pregnancy?

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.