High-Yield NEET SS Medicine Nephrology Questions

Preparing for the NEET SS exam can feel like navigating a maze, but fear not! We have got the perfect strategy to help you gauge your readiness by giving you a sneak peek into the exam format.

Dive into the NEET SS high-yield questions to gain insight into what to expect. Get started by practicing the questions below, boost your confidence and fine tune your NEET SS Medicine preparation.

1. A 54-year-old man visits his doctor for a check-up. He had an emergency heart catheterization three weeks ago due to a myocardial infarction. He was hospitalized for longer than anticipated due to decreased kidney function. The patient claims that his symptoms have improved considerably since then. He is now urinating considerably more than he was before the procedure. His serum creatinine is 1.6 mg/dL, and his blood urea nitrogen concentration is 20 mg/dL. Which of the following problems is this patient more likely to experience?

1. Hypokalemia
2. Hypernatremia
3. Hyporeninemia
4. Metabolic alkalosisc

2. A 32-year-old woman has a history of progressive fatigue, polyuria, and polydipsia. Her father had end-stage renal disease. Laboratory tests reveal increased serum creatinine levels and mild anaemia. Renal ultrasound demonstrates normal kidney size and loss of corticomedullary differentiation. Which genetic mutation causes this condition?

1. HNF1B gene
2. MUC1 gene
3. PKD1 gene
4. COL4A3 gene

3. A 60-year-old male with a history of alcohol abuse presents to the hospital with complaints of abdominal pain, vomiting and distension for the past few weeks. He reports 6 episodes of vomiting in the past 4 hours. On physical examination, there are ascites and jaundice. The patient looked dehydrated and confused. Laboratory investigations reveal hypoalbuminemia, an elevated serum bilirubin level, and coagulopathy consistent with cirrhosis. The patient also has metabolic alkalosis with an arterial blood pH of 7.5 and serum bicarbonate level of 34 mEq/L. Which of the following is a possible cause of metabolic alkalosis in this patient with cirrhosis?

1. Hypokalemia
2. Hypochloremia
3. Hypernatremia
4. Hypercalcemia

4. A 67-year-old male presents to the emergency department due to severe fatigue and muscular weakness for the last 2 days. He is a known case of congestive heart failure and takes captopril, furosemide, metoprolol, and nitrate. Physical examination shows signs of dehydration. His ECG shows the following findings:

Which of the following is most likely to improve the patient’s condition?

1. Potassium
2. Magnesium
3. Calcium
4. Normal saline

5. A 50-year-old male with a history of hypertension and type 2 diabetes presents to the emergency department with complaints of nausea, vomiting, and weakness. His blood pressure is 160/100 mmHg, heart rate is 100 beats per minute, and respiratory rate is 20 breaths per minute. His laboratory results reveal serum potassium levels of 6.5 mmol/L, blood urea nitrogen (BUN) levels of 50 mg/dL, and serum creatinine levels of 3.5 mg/dL. Urinalysis reveals proteinuria and muddy brown casts. The patient is diagnosed with acute kidney injury (AKI) and hyperkalemia. Which of the following is the most appropriate initial treatment for this patient's hyperkalemia?

1. Hemodialysis
2. Intravenous calcium gluconate
3. Intravenous insulin and glucose
4. Oral sodium polystyrene sulfonate (Kayexalate)

6. A 70-year-old male with poor oral intake and vomiting history is admitted to the hospital. He vomits everything he tries to eat. A diagnosis of gastroenteritis is made. His blood pressure is 90/60 mmHg, pulse rate is 110/min, and temperature is 101 F. Laboratory results reveal a serum sodium level of 155 mEq/L. What is the most likely cause of hypernatremia in this patient?

1. Hypovolemic hypernatremia
2. Euvolemic hypernatremia
3. Hypervolemic hypernatremia
4. Pseudohyponatremia

7. A 45-year-old male patient with long-standing chronic kidney disease presents with abdominal pain, nausea, and vomiting. Laboratory tests show a serum calcium level of 12.0 mg/dL (normal range: 8.5-10.2 mg/dL), serum phosphorus level of 5.0 mg/dL (normal range: 2.5-4.5 mg/dL), and a high parathyroid hormone (PTH) level. What is the most likely cause of hypercalcemia in this patient?

1. Excess calcium intake
2. Increased calcium absorption from the gut
3. High serum phosphorus levels
4. Decreased expression of calcium-sensing receptors in the parathyroid

8. A 28-year-old man presents to the clinic with a history of fatigue, muscle weakness, and polyuria for the past six months. He reports excessive thirst and drinks more than 6 liters of water per day. He denies any chest pain, shortness of breath, or palpitations. His past medical history is unremarkable, and he is not taking any medications. On examination, his blood pressure is 110/70 mmHg, and his heart rate is 80 beats per minute. He has mild bilateral lower extremity edema, and his laboratory tests reveal hypokalemia (serum potassium level 2.8 mEq/L), metabolic alkalosis (pH 7.48), elevated serum renin level (20 ng/mL/hour), and elevated serum aldosterone level (20 ng/dL). Genetic testing confirms the presence of the Barttin gene. What is the most likely diagnosis?

1. Liddle syndrome
2. Primary hyperaldosteronism
3. Type 1 Bartter syndrome
4. Type 4A Bartter syndrome

9. A 17-year-old boy's father brings him to the doctor because of a seven-month history of fatigue, recurrent leg cramps, and increased regularity in urinating. His blood pressure is 118/85 mm Hg, and his heartbeat is 94/min. An inspection of the body reveals dry mucous membranes. Serum Na+ is 133 mEq/L, K+ is 2.9 mEq/L, Cl- is 91 mEq/L, Mg2+ is 1.2 mg/dL, Ca2+ is 10.5 mg/dL, and Albumin is 5.3 g/dL. Urinary Ca2+ is 69 mg/24 h, and Cl- is 374 mEq/24h (N = 110-250). An arterial blood gas evaluation on room air reveals a pH of 7.55 and an HCO3- concentration of 45 mEq/L. He is diagnosed to have Gitelman syndrome. Gitelman syndrome mimics which of the following options?

1. Thiazide diuretics
2. Loop diuretics
3. Hypertension
4. Tyrosinemia

10. A 60-year-old male with a history of hypertension and chronic kidney disease (CKD) presents to the emergency department with confusion and altered mental status. He has missed his last few hemodialysis sessions and reports feeling unwell for the past few days. On examination, he appears disoriented and unable to follow commands. The patient's neurological examination reveals asterixis and myoclonus. Laboratory tests reveal a serum creatinine level of 6.5 mg/dL, blood urea nitrogen level of 80 mg/dL, and serum potassium level of 6.8 mEq/L. What is the most likely diagnosis?

1. Cerebral infarction
2. Uremic encephalopathy
3. Wernicke's encephalopathy
4. Acute alcohol intoxication

11. A 75-year-old male patient with end-stage renal disease (ESRD) has been receiving regular hemodialysis for the past five years. Unfortunately, he has recently developed multiple comorbidities, and his overall health has declined. The patient's family is concerned about end-of-life care and wants to know what ethical considerations are involved in dialysis treatment. What are some ethical considerations in end-of-life care for dialysis patients?

1. Continuation of aggressive dialysis treatment
2. Withholding or withdrawing dialysis treatment
3. Delaying dialysis treatment
4. Reducing dialysis treatment frequency

12. A 55-year-old man with a history of renal transplantation has presented with complaints of fever, malaise, and abdominal pain. He underwent transplantation six months ago and is taking immunosuppressive medications. Vital signs are; heart rate of 92/min, blood pressure of 130/90 mmHg, and a temperature of 101F (38.3 C). Physical examination reveals tenderness in the right upper quadrant of the abdomen. Laboratory results show leucocytosis and elevated liver enzymes . What is the most appropriate initial step in management?

1. Start empiric broad-spectrum antibiotics
2. Obtain a CT scan of the abdomen and pelvis
3. Order blood cultures and adjust immunosuppressive medications
4. Perform a liver biopsy

13. A 34-year-old woman presents with oedema, hypertension, and hematuria. On physical examination, his blood pressure is 170/90 mmHg, and he has 3+ pitting oedema in his lower extremities. Urinalysis shows proteinuria (3+) and hematuria. A renal biopsy reveals dense deposits of C3 in the mesangium and along the glomerular basement membrane. The patient is diagnosed with C3 glomerulopathy. Which of the following is the most likely pathophysiological mechanism underlying C3 glomerulopathy?

1. Circulating immune complexes deposit in the glomerular basement membrane and activate complement, leading to inflammation and glomerular injury
2. Mutations in complement regulatory proteins lead to dysregulation of the complement system and excessive activation, leading to glomerular injury
3. Antibodies against podocyte proteins lead to the immune complex formation and complement activation, resulting in glomerular injury
4. Damage to the endothelial cells lining the glomerular capillaries leads to exposure of subendothelial collagen, resulting in complement activation and glomerular injury

14. A 39-year-old female with a history of intravenous heroin use presents with generalised body swelling and fatigue for 1 month. Urinalysis shows proteinuria in the range of nephrotic syndrome. Renal biopsy shows the following findings on light microscopy:

Which of the following is the most likely diagnosis?

1. Focal segmental glomerular sclerosis
2. Minimal change disease
3. Membranous glomerulonephritis
4. Goodpasture’s disease

15. A 48-year-old male presents to the clinic complaining of swelling in his legs and face for the past 4 months. Laboratory investigations reveal hypoalbuminemia, hyperlipidemia, and proteinuria with a urine protein-to-creatinine ratio of 10. A kidney biopsy reveals a thickening of the glomerular basement membrane with spikes and subepithelial deposits. Which of the following is the most likely diagnosis?

1. Focal segmental glomerulosclerosis
2. IgA nephropathy
3. Membranoproliferative glomerulonephritis
4. Membranous nephropathypathy

16. A 32-year-old male with a smoking history presents with cough, dyspnea, and hemoptysis. On examination, he has bilateral crackles in his lungs and decreased urine output. A chest X-ray shows diffuse pulmonary infiltrates, and urinalysis reveals microscopic hematuria. A renal biopsy is performed, and the pathology report shows linear IgG and C3 deposition along the basement membrane. What is the most likely diagnosis?

1. Wegener's granulomatosis
2. Goodpasture syndrome
3. Sarcoidosis
4. Alport syndrome

17. A 55-year-old male presents to the clinic for a follow-up visit 5 days after an upper respiratory tract infection. The patient complained of dark brown urine. On today’s visit, blood pressure was 150/90 mmHg. A suspected diagnosis of IgA nephropathy is made. Urine analysis shows red blood cell casts and proteinuria. Based on the clinical findings, what will be the most likely immunofluorescence (IF) findings in this patient?

1. Negative
2. Mesangial IF
3. Granular starry sky IF
4. Linear IF

18. A 30-year-old woman presents to the medical outpatient department due to periorbital and pedal swelling for 2 days. She has no other complaints. She has no history of any chronic disorder and takes no medications. She reports an episode of upper respiratory tract infection 2 weeks ago. Her blood pressure is noted to be 150/90mmHg. Physical examination reveals periorbital and bilateral pedal oedema. Urine examination reveals haematuria and proteinuria. Which of the following is the most likely diagnosis?

1. Membranous nephropathy
2. Minimal change disease
3. IgA nephropathy
4. Post-streptococcal glomerulonephritis

19. A 60-year-old male patient known case of hypertension came to the outpatient department with symptoms of loss of appetite and difficulty in passing urine for a few days (Associated with foamy urine output). The patient also noted swelling under the eyes, ankles and lower part of the abdomen. The urine report shows 4+ proteinuria, Creatinine 1.4. All other labs were normal. The patient has a family history of kidney failure in first-degree relatives. The nephrologist suggested a kidney biopsy. There was a widening of a gap seen in the space between foot processes. Which of the following is an applicable treatment option for this patient?

1. Plasmapheresis
2. Diet Modification
3. Losartan
4. Mycophenolate Mofetil

20. A 28-year-old pregnant female presents to the outpatient clinic for a routine prenatal visit. She is complaining of excessive thirst and dizziness. She also thinks she has to urinate more often but attributes it to her pregnancy. She is in her third trimester and is expected to deliver soon. A metabolic panel reveals hypernatremia and a high serum osmolality. She is given a container to measure her 24-hour urine volume, which measures 3400 mL the next day. Which of the following is the most likely source of these findings?

1. Anterior pituitary gland
2. Posterior pituitary gland
3. Placenta
4. Fetus

21. A 10-year-old male patient presents to the clinic with a history of recurrent urinary tract infections and abdominal pain. His family history reveals that his older brother died from an end-stage renal disease at 12yrs. On physical examination, the abdomen is distended, and palpation reveals bilateral flank masses. Which diagnostic test is the most appropriate initial step in the evaluation of this patient?

1. Renal biopsy
2. Magnetic resonance imaging (MRI) of the abdomen
3. Ultrasound of the abdomen
4. Computed tomography (CT) of the abdomen

22. A 60-year-old man is hospitalized with shortness of breath and leg swelling. He has a medical history of hypertension, type 2 diabetes and recurrent episodes of bilateral flank pain over the past several years. On physical examination, his blood pressure is 165/100 mm Hg. Laboratory tests reveal an elevated serum creatinine level of 3.0 mg/dL and decreased urine output. CT scan of the abdomen is shown in the image below.

Which of the following is the likely cause of these findings?

1. Renal cyst
2. Medullary sponge kidney
3. Renal cell carcinoma
4. Polycystic kidney disease

23. A 26-year-old female presents to the clinic complaining of swelling in her legs and face, fatigue, and decreased urine output for the past few days. On examination, she has bilateral pedal edema, periorbital edema, and a blood pressure of 150/90 mm Hg. Urine analysis reveals 3+ proteinuria and red blood cell casts. Serologic workup shows a positive antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) antibody. What is the most likely diagnosis?

1. Minimal change disease
2. Focal segmental glomerulosclerosis
3. Granulomatosis with polyangiitis
4. Lupus nephritis

24. A 6-months-old girl is brought to the physician for follow-up after two episodes of urinary tract infections treated with antibiotics in the past 2 months. Her mother told that she developed an allergic reaction to sulfa antibiotics on her last visit. A voiding cystourethrogram is shown. Which of the following is the mechanism of action for the drug required to prevent long-term complications in this patient?

1. Inhibit cell wall synthesis by blocking peptidoglycan crosslinking
2. Inhibition of bacterial folic acid synthesis
3. Create free radicals to damage bacterial DNA
4. Inhibit 30S subunit of bacterial ribosomes

25. A 65-year-old woman has presented to the medical outpatient department with complaints of fatigue, bone pain, and frequent infections. Physical examination is significant for pallor and bone tenderness. Laboratory studies reveal hemoglobin: 9.8 g/dL, serum calcium: 11.5 mg/dL, Serum creatinine is 1.2 mg/dL, and M-spike: 2.5 g/dL in serum protein electrophoresis. Which of the following is this patient's most common clinical presentation of multiple myeloma nephropathy?

1. Nephrotic syndrome
2. Nephritic syndrome
3. Acute kidney injury
4. Chronic kidney disease

Hope you found this blog helpful for your NEET SS Nephrology Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.