NSG 6001 WEEK 3 QUESTIONS
COMPREHENSIVE TEST PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
EXPERT VERIFIED GRADED A+
◉ [3GHI] A 41-year-old man is found unconscious and brought to
the hospital. The physical examination confirms jaundice. An
abdominal CT scan shows a uniformly enlarged liver while the
laboratory studies show abnormal liver function tests. Microscopic
exam (liver biopsy) reveals abundant Mallory's hyaline, neutrophilic
infiltrates, necrosis of hepatocytes, and extensive macrovesicular fat
deposition. Which one of the following is the likely diagnosis?
A: Primary biliary cirrhosis
B: Chronic hepatitis B infection
C: Alcoholic hepatitis
D: Acetaminophen toxicity
E: Viral hepatitis. Answer: C: Alcoholic hepatitis
Alcohol-related liver disease is damage to hepatic parenchyma due
to consumption of alcohol. It is most common cause of liver disease
in Western world. Fatty liver is accumulation of fat in hepatocytes,
resulting in heavy, greasy liver. Circular cytoplasmic inclusions of
white fat are seen but it resolves w/ abstinence. Alcoholic hepatitis
is acetaldehyde-mediated chemical injury to hepatocytes due to
binge drinking. Swelling or ballooning of hepatocytes is seen on
,histology, as well as Mallory bodies, i.e. damaged intermediate
filaments within hepatocytes. It presents w/ painful hepatomegaly &
elevated liver enzymes, esp. AST > ALT.
◉ [3GHI] A 46-year-old man attends your family medicine clinic for
a routine checkup. He has read that one daily alcoholic drink three
times a week is good for health. What is your response?
A. Do not exceed 7 drinks per week
B. Medically, there is zero tolerance to alcohol
C. Only red wine is fine
D. Only wine and beer are permissible
E. Do not drink on an empty stomach. Answer: B. Medically, there is
zero tolerance to alcohol
◉ [3GHI] A 32-year-old man presents with fever, nausea, and
jaundice. Since he is an airline pilot, he indulges in large amounts of
alcohol during his layover in different countries. A diagnosis of
alcoholic hepatitis is entertained. Which one of the following is true
for alcoholic hepatitis?
A. AST > ALT
B. Hyaline inclusion bodies are diagnostic
C. Obesity does not cause fatty liver seen with alcohol
D. Alcoholic hepatitis is limited to the upper social classes
,E. Alcoholic hepatitis damage is independent of malnutrition.
Answer: A. AST > ALT
◉ [3GHI] A 36-year-old female was out in the woods during late
summer and soon developed a rash and arthralgia. She was
immediately started on a drug. 3 weeks later, a biopsy of the liver
revealed microvesicular fatty changes. What drug was used?
A. Tetracycline
B. Gentamycin
C. Trimethoprim/sulfamethoxazole
D. Oral estrogens
E. Sulfanamide. Answer: A. Tetracycline
High doses of IV tetracycline can induce fatty liver disease and may
result in severe hepatic dysfunction, acute liver failure, and death.
This is more common among pregnant women, hence why
tetracyclines are teratogenic.
◉ [3GHI] A 33-year-old woman presents with a two-week history of
a right upper quadrant sharp abdominal pain and nausea. She also
has noticed jaundice during this time that appears to have become
more pronounced over the last several days. She denies any recent
sexual partners or history of intravenous drug use. The patient
drinks socially and does not smoke. Autoimmune workup reveals a
positive antinuclear antibody and positive anti-smooth muscle
antibody. Anti-mitochondrial antibodies are negative. A liver biopsy
, is obtained and shows only interface (piecemeal) hepatitis. Which
one of the following is the likely cause of her hepatitis?
A: Autoimmune
B: Non-alcoholic fatty liver disease
C: Hepatitis C virus
D: Drugs
E: Alcohol. Answer: A: Autoimmune
Autoimmune hepatitis is chronic, self-perpetuating liver
inflammation. Although mechanism is unknown, there is likely some
triggering agent (drug, virus, toxin, etc.) combined w/ genetic
predisposition (HLA-DR3 & HLA-DR4) that results in reduced
number of suppressor T lymphocytes. Cytotoxic T-cells attack
hepatocytes, & there are autoantibodies, specifically antinuclear
antibody (ANA) & smooth muscle antibodies (SMA). Gamma
globulin is also increased twofold. It affects women more than men.
Histologically, there is piecemeal necrosis aka interface hepatitis.
◉ [3GHI] A 14-year-old girl has flu-like symptoms for a week. Based
on the laboratory work-up, a diagnosis of Cytomegalovirus (CMV)
hepatitis is made. On a liver biopsy, which one of the following
would be diagnostic of this condition?
A: "Owl Eye" intranuclear inclusions in hepatocytes
B: Piecemeal necrosis at the portal triad
C: Bridging necrosis with monocyte infiltration
D: Apoptotic liver cells with "dropout" necrosis
COMPREHENSIVE TEST PAPER 2026
COMPLETE QUESTIONS AND ANSWERS
EXPERT VERIFIED GRADED A+
◉ [3GHI] A 41-year-old man is found unconscious and brought to
the hospital. The physical examination confirms jaundice. An
abdominal CT scan shows a uniformly enlarged liver while the
laboratory studies show abnormal liver function tests. Microscopic
exam (liver biopsy) reveals abundant Mallory's hyaline, neutrophilic
infiltrates, necrosis of hepatocytes, and extensive macrovesicular fat
deposition. Which one of the following is the likely diagnosis?
A: Primary biliary cirrhosis
B: Chronic hepatitis B infection
C: Alcoholic hepatitis
D: Acetaminophen toxicity
E: Viral hepatitis. Answer: C: Alcoholic hepatitis
Alcohol-related liver disease is damage to hepatic parenchyma due
to consumption of alcohol. It is most common cause of liver disease
in Western world. Fatty liver is accumulation of fat in hepatocytes,
resulting in heavy, greasy liver. Circular cytoplasmic inclusions of
white fat are seen but it resolves w/ abstinence. Alcoholic hepatitis
is acetaldehyde-mediated chemical injury to hepatocytes due to
binge drinking. Swelling or ballooning of hepatocytes is seen on
,histology, as well as Mallory bodies, i.e. damaged intermediate
filaments within hepatocytes. It presents w/ painful hepatomegaly &
elevated liver enzymes, esp. AST > ALT.
◉ [3GHI] A 46-year-old man attends your family medicine clinic for
a routine checkup. He has read that one daily alcoholic drink three
times a week is good for health. What is your response?
A. Do not exceed 7 drinks per week
B. Medically, there is zero tolerance to alcohol
C. Only red wine is fine
D. Only wine and beer are permissible
E. Do not drink on an empty stomach. Answer: B. Medically, there is
zero tolerance to alcohol
◉ [3GHI] A 32-year-old man presents with fever, nausea, and
jaundice. Since he is an airline pilot, he indulges in large amounts of
alcohol during his layover in different countries. A diagnosis of
alcoholic hepatitis is entertained. Which one of the following is true
for alcoholic hepatitis?
A. AST > ALT
B. Hyaline inclusion bodies are diagnostic
C. Obesity does not cause fatty liver seen with alcohol
D. Alcoholic hepatitis is limited to the upper social classes
,E. Alcoholic hepatitis damage is independent of malnutrition.
Answer: A. AST > ALT
◉ [3GHI] A 36-year-old female was out in the woods during late
summer and soon developed a rash and arthralgia. She was
immediately started on a drug. 3 weeks later, a biopsy of the liver
revealed microvesicular fatty changes. What drug was used?
A. Tetracycline
B. Gentamycin
C. Trimethoprim/sulfamethoxazole
D. Oral estrogens
E. Sulfanamide. Answer: A. Tetracycline
High doses of IV tetracycline can induce fatty liver disease and may
result in severe hepatic dysfunction, acute liver failure, and death.
This is more common among pregnant women, hence why
tetracyclines are teratogenic.
◉ [3GHI] A 33-year-old woman presents with a two-week history of
a right upper quadrant sharp abdominal pain and nausea. She also
has noticed jaundice during this time that appears to have become
more pronounced over the last several days. She denies any recent
sexual partners or history of intravenous drug use. The patient
drinks socially and does not smoke. Autoimmune workup reveals a
positive antinuclear antibody and positive anti-smooth muscle
antibody. Anti-mitochondrial antibodies are negative. A liver biopsy
, is obtained and shows only interface (piecemeal) hepatitis. Which
one of the following is the likely cause of her hepatitis?
A: Autoimmune
B: Non-alcoholic fatty liver disease
C: Hepatitis C virus
D: Drugs
E: Alcohol. Answer: A: Autoimmune
Autoimmune hepatitis is chronic, self-perpetuating liver
inflammation. Although mechanism is unknown, there is likely some
triggering agent (drug, virus, toxin, etc.) combined w/ genetic
predisposition (HLA-DR3 & HLA-DR4) that results in reduced
number of suppressor T lymphocytes. Cytotoxic T-cells attack
hepatocytes, & there are autoantibodies, specifically antinuclear
antibody (ANA) & smooth muscle antibodies (SMA). Gamma
globulin is also increased twofold. It affects women more than men.
Histologically, there is piecemeal necrosis aka interface hepatitis.
◉ [3GHI] A 14-year-old girl has flu-like symptoms for a week. Based
on the laboratory work-up, a diagnosis of Cytomegalovirus (CMV)
hepatitis is made. On a liver biopsy, which one of the following
would be diagnostic of this condition?
A: "Owl Eye" intranuclear inclusions in hepatocytes
B: Piecemeal necrosis at the portal triad
C: Bridging necrosis with monocyte infiltration
D: Apoptotic liver cells with "dropout" necrosis
