This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Urinary tract, Subject name: Pathology
Necrotizing papillitis may be seen in all of the following conditions except 
Select and explain. 
A. Sickle cell disease, B. Tuberous pyelonephritis, C. Diabetes mellitus, D. Analgesic nephropathy
B: Tuberous pyelonephritis
Answer: B: Tuberous pyelonephritis 
Explanation: Necrotizing papillitis is the other name of acute papillary necrosis . When infection of renal pyramid develop in association with vascular diseases of kidney or with urinary tract obstruction ,renal papillary necrosis is likely to result. Diabetes mellitus Sickle cell disease Chronic alcoholism Vascular diseases Analgesic abuse nephropathy Refer robbins 7/1004 9/e p936