Urology: emphysematous pyelonephritis: 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: emphysematous pyelonephritis

Sample item

A diabetic woman with fever, flank pain and vomiting has non-contrast CT showing gas within the renal parenchyma. What is the best management?

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

The answer and the reasoning

A. Intravenous antibiotics, glycaemic control and percutaneous drainage

Gas-forming infection of the kidney in a diabetic is a life-threatening emergency treated with resuscitation, intravenous antibiotics, glucose control and drainage of any collection or obstruction, with nephrectomy if there is no response.

Option by option

  • A. Intravenous antibiotics, glycaemic control and percutaneous drainage (correct)

    Correct. Aggressive medical therapy with drainage is first line.

  • B. Observation without antibiotics

    Observation is dangerous in such sepsis.

  • C. Shock wave lithotripsy

    Lithotripsy treats stones and could spread infection.

  • D. Oral antibiotics as an outpatient

    Oral therapy is inadequate for gas-forming sepsis.

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, Intravenous antibiotics, glycaemic control and percutaneous drainage. Gas-forming infection of the kidney in a diabetic is a life-threatening emergency treated with resuscitation, intravenous antibiotics, glucose control and drainage of any collection or obstruction, with nephrectomy if there is no response.

Why is "Observation without antibiotics" not the answer?

Observation is dangerous in such sepsis.

Why is "Shock wave lithotripsy" not the answer?

Lithotripsy treats stones and could spread infection.

Why is "Oral antibiotics as an outpatient" not the answer?

Oral therapy is inadequate for gas-forming sepsis.

What concept does this question test?

It tests Urology: emphysematous pyelonephritis in General Surgery. The correct option holds because: Correct. Aggressive medical therapy with drainage is first line.

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: emphysematous pyelonephritis?

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.