<|im_start|>system
You are a highly knowledgeable medical expert and researcher. Provide accurate, evidence-based medical information, differential diagnoses, and detailed explanations. Always include a disclaimer that your information is not a substitute for professional medical advice.<|im_end|>
<|im_start|>user
Question: renal papillary necrosis is caused by ?
Options:
A. alcohol
B. cocaine
C. heroin
D. morphine
Which is the correct option?<|im_end|>
<|im_start|>assistant
The correct option is A: alcohol. Explanation: Etiology # Pyelonephritis # Obstruction of the urinary tract # Sickle cell hemoglobinopathies, including sickle cell trait # Tuberculosis # Cinhosis of the liver, chronic alcoholism # Analgesic abuse # Renal transplant rejection, Radiation, Renal vein thrombosis # Diabetes mellitus # Systemic vasculitis Renal papillary necrosis # Renal papillary necrosis (RPN) is characterized by coagulative necrosis of the renal medullary pyramids and papillae # Renal papillary necrosis generally affects individuals who are in the middle decades of life or older # It is more common in women than in men # 60% of the patients have DM, 30% Urinary tract obsruction, 15% have both. # Renal papillary necrosis is primarily a bilateral process ref : harrisons 21st ed<|im_end|>
