Renal imaging: emphysematous pyelonephritis: 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: emphysematous pyelonephritis

Sample item

A diabetic woman has fever, flank pain and septic shock. CT shows gas replacing much of the renal parenchyma with little normal tissue. What is the diagnosis and approach?

AEmphysematous pyelonephritis, requiring resuscitation, antibiotics and urgent drainage or nephrectomyBSimple cystitis managed with oral antibioticsCRenal calculus managed conservativelyDXanthogranulomatous pyelonephritis managed electively

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

The answer and the reasoning

A. Emphysematous pyelonephritis, requiring resuscitation, antibiotics and urgent drainage or nephrectomy

Gas-forming organisms in a diabetic kidney cause emphysematous pyelonephritis, a surgical emergency with high mortality. CT delineates extent and obstruction, which guides percutaneous drainage or nephrectomy. Xanthogranulomatous disease is chronic and does not contain gas.

Option by option

A. Emphysematous pyelonephritis, requiring resuscitation, antibiotics and urgent drainage or nephrectomy (correct)
Correct. Parenchymal gas in a septic diabetic indicates emphysematous pyelonephritis.
B. Simple cystitis managed with oral antibiotics
Cystitis does not cause renal gas or shock.
C. Renal calculus managed conservatively
A stone alone does not explain parenchymal gas.
D. Xanthogranulomatous pyelonephritis managed electively
XGP is subacute and gas-free.

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.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Emphysematous pyelonephritis, requiring resuscitation, antibiotics and urgent drainage or nephrectomy. Gas-forming organisms in a diabetic kidney cause emphysematous pyelonephritis, a surgical emergency with high mortality.

Why is "Simple cystitis managed with oral antibiotics" not the answer?

Cystitis does not cause renal gas or shock.

Why is "Renal calculus managed conservatively" not the answer?

A stone alone does not explain parenchymal gas.

Why is "Xanthogranulomatous pyelonephritis managed electively" not the answer?

XGP is subacute and gas-free.

What concept does this question test?

It tests Renal imaging: emphysematous pyelonephritis in Radiology. CT delineates extent and obstruction, which guides percutaneous drainage or nephrectomy. Xanthogranulomatous disease is chronic and does not contain gas.

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: emphysematous pyelonephritis?

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.