Liver and Biliary Pathology Practice Questions

Q: Which of the following is NOT true regarding Gilbert syndrome?

It causes cirrhosis. **Explanation:** **Gilbert Syndrome** is a common, benign hereditary condition characterized by mild, unconjugated hyperbilirubinemia [1]. **1. Why Option A is the Correct Answer (The False Statement):** Gilbert syndrome is a **benign condition** and does **not** lead to progressive liver damage, fibrosis, or **cirrhosis**. The liver remains structurally and functionally intact despite the intermittent jaundice [1]. **2. Analysis of Other Options:** * **Option B (Inheritance):** While most commonly associated with an autosomal recessive mutation in the *UGT1A1* gene promoter (TATAA box), it is clinically often described as having an **autosomal dominant** pattern of inheritance with variable penetrance in many medical texts, making this statement generally accepted as true in the context of competitive exams [1]. * **Option C (Liver Function Tests):** Apart from isolated elevations in indirect (unconjugated) bilirubin, standard LFTs (ALT, AST, Alkaline Phosphatase, and Albumin) are **typically normal**. * **Option D (Liver Histology):** The architecture of the liver is preserved. On biopsy, the **liver histology is normal**, though occasionally a slight increase in lipofuscin pigment may be noted [1]. **NEET-PG High-Yield Pearls:** * **Defect:** Reduced activity (approx. 30% of normal) of the enzyme **UDP-glucuronosyltransferase (UGT1A1)** [1]. * **Triggers:** Jaundice is typically precipitated by **stress, fasting, strenuous exercise, or illness**. * **Diagnosis:** Suggested by a rise in bilirubin after a 48-hour fast (Fasting test). * **Treatment:** No treatment is required; reassurance is the mainstay of management. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Liver and Gallbladder, p. 860.

Question 1

A liver biopsy specimen shows Mallory hyaline. Which of the following conditions would you exclude from the diagnosis?

Accepted Answer

Hepatitis E

Answer

Alcoholic liver disease

Answer

Hepatocellular carcinoma

Answer

Wilson's syndrome

Question 2

Centrizonal necrosis of the liver occurs with which of the following?

Accepted Answer

Heart failure (CHF)

Answer

Carbon tetrachloride (CCl4) toxicity

Answer

Smoking (chronic)

Answer

Chronic alcoholism

Question 3

Which of the following is NOT a feature of non-cirrhotic portal hypertension?

Accepted Answer

Ascites

Answer

Hematemesis

Answer

Splenomegaly

Answer

All are seen

Question 4

What is the primary site of involvement in congenital tuberculosis?

Accepted Answer

Liver

Answer

Lungs

Answer

Lymph nodes

Answer

Stomach

Question 5

Which of the following is NOT true regarding Gilbert syndrome?

Accepted Answer

It causes cirrhosis

Answer

It is inherited in an autosomal dominant pattern

Answer

Liver function tests are typically normal

Answer

Liver histology is typically normal

Question 6

Which mechanism plays the dominant role in regenerative repair after chronic liver injury or inflammation?

Accepted Answer

Repopulation from progenitor cells

Answer

Proliferation of the residual hepatocytes

Answer

Replacement of parenchymal cells by collagen

Answer

Both proliferation of residual hepatocytes and repopulation from progenitor cells

Question 7

An alcoholic presented with ascites, bloody tap, and elevated alpha-fetoprotein. What is the most likely diagnosis?

Accepted Answer

Hepatocellular Carcinoma

Answer

Choriocarcinoma

Answer

Acute hemorrhagic pancreatitis

Answer

Pancreatic carcinoma

Question 8

Non-alcoholic steatohepatitis is seen in all, except:

Accepted Answer

Gallstone disease

Answer

Diabetes

Answer

Obesity

Answer

Hypertriglyceridemia

Question 9

All are features of hepatocellular carcinoma, except?

Accepted Answer

Not common in Asian populations

Answer

Liver biopsy is diagnostic

Answer

Raised titre of HBV and HCV antibodies

Answer

Fibrolamellar type has a good prognosis

Question 10

The hepatotoxic octapeptides of Amanita phalloides usually produce which of the following types of liver injury?

Accepted Answer

Massive hepatic necrosis

Answer

Centrilobular zonal necrosis

Answer

Periportal injury

Answer

Granuloma formation in liver

Liver and Biliary Pathology — MCQs

Liver and Biliary Pathology — MCQs

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