Nephrology: practice question

A Pediatrics 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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Pediatrics · Nephrology

Sample item

A 4-year-old boy has puffy eyelids, heavy proteinuria, low serum albumin, normal blood pressure and no haematuria. What is the first-line treatment?

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

The answer and the reasoning

C. Oral prednisolone

In this age group nephrotic syndrome is usually minimal change disease, which responds to corticosteroids. Biopsy is not needed at the outset when there are no atypical features, such as haematuria, hypertension or low complement. Other immunosuppressants are for steroid resistance or frequent relapses.

Option by option

  • A. ACE inhibitor alone

    An ACE inhibitor lowers proteinuria modestly but does not treat minimal change disease.

  • B. Renal biopsy before any treatment

    Biopsy is reserved for atypical features or steroid resistance.

  • C. Oral prednisolone (correct)

    Correct. Most children remit with a course of prednisolone.

  • D. Cyclophosphamide

    Cyclophosphamide is used for frequent relapses or steroid dependence, not first-line.

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.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Oral prednisolone. In this age group nephrotic syndrome is usually minimal change disease, which responds to corticosteroids.

Why is "ACE inhibitor alone" not the answer?

An ACE inhibitor lowers proteinuria modestly but does not treat minimal change disease.

Why is "Renal biopsy before any treatment" not the answer?

Biopsy is reserved for atypical features or steroid resistance.

Why is "Cyclophosphamide" not the answer?

Cyclophosphamide is used for frequent relapses or steroid dependence, not first-line.

What concept does this question test?

It tests Nephrology in Pediatrics. Biopsy is not needed at the outset when there are no atypical features, such as haematuria, hypertension or low complement. Other immunosuppressants are for steroid resistance or frequent relapses.

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 Nephrology?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.