Urology: xanthogranulomatous 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: xanthogranulomatous pyelonephritis

Sample item

A middle-aged woman with recurrent Proteus urinary infections and a staghorn calculus has a non-functioning enlarged kidney. Histology shows lipid-laden foamy macrophages. What is the treatment?

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

The answer and the reasoning

D. Nephrectomy

Xanthogranulomatous pyelonephritis is a chronic suppurative process with obstructing stone and a non-functioning kidney that mimics a tumour. Treatment is antibiotics followed by nephrectomy.

Option by option

  • A. Pyeloplasty

    Pyeloplasty is for pelviureteric obstruction in a functioning kidney.

  • B. Shock wave lithotripsy

    Lithotripsy cannot clear a large staghorn in a destroyed kidney.

  • C. Long-term antibiotics alone

    Antibiotics alone do not clear the obstructed, destroyed kidney.

  • D. Nephrectomy (correct)

    Correct. A non-functioning kidney with this pathology is removed.

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 D, Nephrectomy. Xanthogranulomatous pyelonephritis is a chronic suppurative process with obstructing stone and a non-functioning kidney that mimics a tumour.

Why is "Pyeloplasty" not the answer?

Pyeloplasty is for pelviureteric obstruction in a functioning kidney.

Why is "Shock wave lithotripsy" not the answer?

Lithotripsy cannot clear a large staghorn in a destroyed kidney.

Why is "Long-term antibiotics alone" not the answer?

Antibiotics alone do not clear the obstructed, destroyed kidney.

What concept does this question test?

It tests Urology: xanthogranulomatous pyelonephritis in General Surgery. Treatment is antibiotics followed by nephrectomy.

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: xanthogranulomatous 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.