AssessmentsRenal papillary necrosis
Renal papillary necrosis
USMLE® Step 1 style questions USMLE
A 56-year-old woman comes to the office because of a 1-week history of left flank pain. Her medical history is relevant for fibromyalgia and osteoarthritis. She currently takes low-dose aspirin, acetaminophen, and ibuprofen. Upon further interrogation, the patient claims no relief of her symptoms despite taking more pain medication than usual. She also noticed an increased urinary frequency and "cloudy and pink" urine. Physical exam shows dry skin and conjunctivae. Her temperature is 36.5°C (97.7°F), pulse is 91/min, respirations are 16/min, blood pressure is 140/90 mmHg. An abdominal CT scan reveals an atrophic and small left kidney with papillary calcifications. This patient most likely has which of the following conditions?