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 Q - renin  

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previously healthy 56yr old man has sudden onset of severe headache that become worse in afternoons, His bp - 180/110mm hg. Renal angiography - 85% occlusion of rt renal artery. lab findings best predicts whether an operation that relieves the obstruction wil reduce bp to normal. inc renin activity seen in

1 . left renal a & right renal a renal vein & rt renal vein
3.rt renal a & lt renal a
4. rt renal vein & left renal vein

pls ans with expl. thanq


I think its 4...........don't ask me why grin



brainstem i think the Q must be asking inc renin activity as compared to the other one.. then it must be 4..


y not 3


renin is secreted bythe kidney.. so it will go in the renal vein to the systemic circulation.. as the stenosis is in rt kidney, so this side will be secreting more renin than the left..


y not into artery?




As blood goes round and round , you could detect it also in artery. grin Sorry , could not help myself to say it.

Seriously, it should be in right renal vein higher as it leaves the kidney, but should not be on left kidney normal level of renin as there is normal RBF ?


Sadly this is an NBME question. I know this cos i have doen this and there were discussions on this question quite a lot on the forum.

well its the Right Renal Artey Being Constricted therefore its concerntration of Renin in its Vein will be increased as compared to the Left Renal Vein which has no constriction of Artey but will express the Constriction due to Presence of INC Renin Plamsa values but itself wont secrete renin.

Now i was oscillating bw Choices 2 and 4 wondering which wud be the correct one but in the end went 4 cos the pathology is in the Right Kidney.


The level of renin secretion in the normal kidney should be lower than normal as the Inc Renin from Right side would increase Ang II and thus this Ang 2 would suppress the normal renal secretion on the left side.

The stenosis is the reason for continual renin release.



it was said on the forum many times, make sure the NBME questions have in head title that are from NBME when you know that .


k GG , i wil follow that frm now.

convinced with NNL expl. thanks. wish u glnod


I know you will, thanks. smiling face

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