Nephrology: emphysematous pyelonephritis: 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.

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General Medicine · Nephrology: emphysematous pyelonephritis

Sample item

A diabetic woman has fever, flank pain and septic shock. Which CT finding confirms emphysematous pyelonephritis?

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

The answer and the reasoning

C. Gas within the renal parenchyma and perinephric tissue

Emphysematous pyelonephritis is a necrotising infection, usually by Escherichia coli or Klebsiella, in diabetic patients, producing gas in the kidney. CT is the investigation of choice. Treatment includes antibiotics, glycaemic control and drainage or nephrectomy in severe cases.

Option by option

  • A. A solitary simple cyst

    A simple cyst does not explain septic shock.

  • B. Bilateral hydronephrosis only

    Hydronephrosis alone does not indicate gas-forming infection.

  • C. Gas within the renal parenchyma and perinephric tissue (correct)

    Correct. Parenchymal gas on CT is diagnostic.

  • D. A horseshoe kidney

    A horseshoe kidney is an anatomical variant.

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 Medicine question

What is the answer to this General Medicine question?

The best answer is C, Gas within the renal parenchyma and perinephric tissue. Emphysematous pyelonephritis is a necrotising infection, usually by Escherichia coli or Klebsiella, in diabetic patients, producing gas in the kidney.

Why is "A solitary simple cyst" not the answer?

A simple cyst does not explain septic shock.

Why is "Bilateral hydronephrosis only" not the answer?

Hydronephrosis alone does not indicate gas-forming infection.

Why is "A horseshoe kidney" not the answer?

A horseshoe kidney is an anatomical variant.

What concept does this question test?

It tests Nephrology: emphysematous pyelonephritis in General Medicine. CT is the investigation of choice. Treatment includes antibiotics, glycaemic control and drainage or nephrectomy in severe cases.

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: emphysematous pyelonephritis?

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.