Nephrology: analgesic nephropathy: practice question

A General Medicine 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.

Try it

General Medicine · Nephrology: analgesic nephropathy

Sample item

A 60-year-old woman with chronic headaches who has taken combination analgesics for 20 years has sterile pyuria and chronic kidney disease. CT shows papillary calcification. What is the underlying pathology?

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

The answer and the reasoning

C. Renal papillary necrosis with chronic interstitial nephritis

Long-term use of combination analgesics, especially with phenacetin or NSAIDs, causes papillary necrosis and chronic tubulointerstitial nephritis. It presents with sterile pyuria, haematuria and CKD, and sloughed papillae may cause colic. Stopping the drugs slows progression.

Option by option

  • A. Membranous glomerulonephritis

    Membranous nephropathy presents with nephrotic syndrome.

  • B. Acute tubular necrosis from ischaemia

    ATN is an acute ischaemic or toxic injury, not a chronic process.

  • C. Renal papillary necrosis with chronic interstitial nephritis (correct)

    Correct. Chronic analgesic use damages the renal papillae and interstitium.

  • D. Polycystic kidney disease

    Polycystic kidneys show multiple cysts and not papillary 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.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Renal papillary necrosis with chronic interstitial nephritis. Long-term use of combination analgesics, especially with phenacetin or NSAIDs, causes papillary necrosis and chronic tubulointerstitial nephritis.

Why is "Membranous glomerulonephritis" not the answer?

Membranous nephropathy presents with nephrotic syndrome.

Why is "Acute tubular necrosis from ischaemia" not the answer?

ATN is an acute ischaemic or toxic injury, not a chronic process.

Why is "Polycystic kidney disease" not the answer?

Polycystic kidneys show multiple cysts and not papillary calcification.

What concept does this question test?

It tests Nephrology: analgesic nephropathy in General Medicine. It presents with sterile pyuria, haematuria and CKD, and sloughed papillae may cause colic. Stopping the drugs slows progression.

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: analgesic nephropathy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.