Indinavir Crystal Nephropathy Radiolucent Stone — ESENeph MCQ

Correct answer: C — Give antibiotics and urgently decompress the infected obstructed system

The best answer is “Give antibiotics and urgently decompress the infected obstructed system”. An infected obstructed collecting system can rapidly cause septic shock and further kidney injury; urgent drainage by stent or nephrostomy accompanies antimicrobial and resuscitation care. “Use expulsive treatment after controlling infection and confirming drainage” is less appropriate because infection plus obstruction is a urological emergency “Perform metabolic stone testing after urgent infection management” is less appropriate because source control takes precedence over prevention work-up “Give analgesia while arranging infection treatment and drainage” is less appropriate because analgesia does not treat sepsis or obstruction “Begin empirical antibiotics before culture sensitivities become available” is less appropriate because empirical treatment and drainage should not be delayed

Reference: NICE NG118: renal and ureteric stones: https://www.nice.org.uk/guidance/ng118/chapter/recommendations