Urology: medullary sponge kidney: practice question

A General Surgery 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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General Surgery · Urology: medullary sponge kidney

Sample item

A 35-year-old woman with recurrent calcium stones and normal renal function has an intravenous urogram showing a linear brush-like blush in the papillae with small cystic dilatations of the collecting ducts in both kidneys. What is the diagnosis?

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

The answer and the reasoning

A. Medullary sponge kidney

Medullary sponge kidney is a developmental dilatation of the collecting ducts in the renal pyramids, giving a paintbrush appearance on contrast study. It is associated with hypercalciuria, stones and infections, but renal function is usually preserved.

Option by option

  • A. Medullary sponge kidney (correct)

    Correct. Ectatic collecting ducts give a brush-like blush and predispose to calcium stones.

  • B. Adult polycystic kidney disease

    Polycystic disease produces large cysts distorting the kidneys and progressive renal impairment.

  • C. Renal papillary necrosis

    Papillary necrosis shows sloughed papillae with ring shadows or cavities at the calyces, usually in analgesic or diabetic patients.

  • D. Distal renal tubular acidosis

    Distal tubular acidosis causes nephrocalcinosis and stones but does not give ductal ectasia.

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 General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Medullary sponge kidney. Medullary sponge kidney is a developmental dilatation of the collecting ducts in the renal pyramids, giving a paintbrush appearance on contrast study.

Why is "Adult polycystic kidney disease" not the answer?

Polycystic disease produces large cysts distorting the kidneys and progressive renal impairment.

Why is "Renal papillary necrosis" not the answer?

Papillary necrosis shows sloughed papillae with ring shadows or cavities at the calyces, usually in analgesic or diabetic patients.

Why is "Distal renal tubular acidosis" not the answer?

Distal tubular acidosis causes nephrocalcinosis and stones but does not give ductal ectasia.

What concept does this question test?

It tests Urology: medullary sponge kidney in General Surgery. It is associated with hypercalciuria, stones and infections, but renal function is usually preserved.

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 Urology: medullary sponge kidney?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.