Renal imaging: medullary sponge kidney: practice question

A Radiology 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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Radiology · Renal imaging: medullary sponge kidney

Sample item

A young adult with recurrent renal colic has multiple small calcifications clustered in the renal pyramids on a plain film. IVU shows linear, brush-like streaks of contrast in the papillae. What is the diagnosis?

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

The answer and the reasoning

B. Medullary sponge kidney

Cystic dilatation of the collecting ducts in the pyramids lets contrast fill them as a brush or bouquet of flowers, and calculi form within the ectatic tubules. It is usually benign and detected on IVU or CT urography.

Option by option

  • A. Renal cell carcinoma

    Renal cell carcinoma is a focal mass.

  • B. Medullary sponge kidney (correct)

    Correct. A brush-like medullary blush with calcification is typical.

  • C. Nephrocalcinosis from distal renal tubular acidosis only

    Nephrocalcinosis can look similar on a plain film, but it does not give the contrast pooling in ectatic ducts.

  • D. Renal artery stenosis

    Renal artery stenosis does not cause medullary calcification.

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 Radiology question

What is the answer to this Radiology question?

The best answer is B, Medullary sponge kidney. Cystic dilatation of the collecting ducts in the pyramids lets contrast fill them as a brush or bouquet of flowers, and calculi form within the ectatic tubules.

Why is "Renal cell carcinoma" not the answer?

Renal cell carcinoma is a focal mass.

Why is "Nephrocalcinosis from distal renal tubular acidosis only" not the answer?

Nephrocalcinosis can look similar on a plain film, but it does not give the contrast pooling in ectatic ducts.

Why is "Renal artery stenosis" not the answer?

Renal artery stenosis does not cause medullary calcification.

What concept does this question test?

It tests Renal imaging: medullary sponge kidney in Radiology. It is usually benign and detected on IVU or CT urography.

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 Renal imaging: medullary sponge kidney?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.