Cirrhosis and Liver Pathology Quiz

In the context of Ghanaian epidemiology, which co-factor significantly amplifies the risk of cirrhosis in patients with chronic hepatitis B infection?

• Alcohol consumption

• Aflatoxin exposure

• Coinfection with hepatitis D

• Hemochromatosis

Which histopathological feature distinguishes micronodular from macronodular cirrhosis?

• Degree of intrahepatic vascular shunting

• Nodule size and degree of fibrosis around portal tracts

• Presence of fatty infiltration

• Degree of cholestasis

The natural course of cirrhosis transitions from compensated to decompensated stage primarily due to:

• Progressive hepatocyte apoptosis

• Development of portosystemic collaterals and worsening portal hypertension

• Autoimmune destruction

• Viral reactivation cycles

Which of the following cytokines plays a central role in the progression of liver fibrosis in cirrhosis?

• Interleukin-6

• Tumor necrosis factor-alpha (TNF-α)

• Transforming growth factor-beta (TGF-β)

• Interferon-gamma

The degree of hepatic fibrosis in cirrhosis is most accurately staged using which of the following?

• METAVIR scoring system

• Child-Pugh score

• MELD score

• Ishak Score

Which laboratory parameter best correlates with the severity of portal hypertension and risk of variceal hemorrhage?

• Serum albumin level

• Platelet count reduction

• Serum bilirubin level

• Prothrombin time prolongation

Regarding the pathogenesis of hepatocellular carcinoma in cirrhotic patients, which molecular pathway is most often activated?

• WNT/β-catenin pathway

• Hedgehog pathway

• Notch pathway

• mTOR pathway

In cirrhotic patients, spontaneous bacterial peritonitis (SBP) is most commonly caused by:

• Escherichia coli

• Pseudomonas aeruginosa

• Enterococcus faecalis

• Staphylococcus aureus

Which prognostic index incorporates bilirubin, INR, and serum creatinine to predict mortality in advanced liver disease?

• MELD score

• Child-Pugh score

• APACHE II score

• Rockall score

Which is an example of a reversible cause of cirrhosis that, if identified early, can lead to significant regression?

• Chronic viral hepatitis

• Autoimmune hepatitis

• Toxin-induced injury (e.g., alcohol, drugs)

• Hemochromatosis