Hepatic pathology: metabolic liver disease: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Hepatic pathology: metabolic liver disease

Sample item

A 45-year-old man has diabetes, bronze skin pigmentation and hepatomegaly. A liver biopsy shows abundant hepatocyte pigment that stains blue with Perls stain. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Hereditary haemochromatosis

Hereditary haemochromatosis, usually due to HFE C282Y homozygosity, causes iron overload with cirrhosis, diabetes, skin pigmentation, cardiomyopathy and hypogonadism, and raises the risk of hepatocellular carcinoma. Perls Prussian blue stain identifies haemosiderin.

Option by option

  • A. Hereditary haemochromatosis (correct)

    Correct. Perls-positive iron deposition fits the picture.

  • B. Primary biliary cholangitis

    Primary biliary cholangitis shows florid duct lesions and anti-mitochondrial antibodies.

  • C. Wilson disease

    Wilson disease causes copper deposition, detected by rhodanine, with Kayser-Fleischer rings.

  • D. Alpha-1 antitrypsin deficiency

    Alpha-1 antitrypsin deficiency shows PAS-positive, diastase-resistant globules.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Hereditary haemochromatosis. Hereditary haemochromatosis, usually due to HFE C282Y homozygosity, causes iron overload with cirrhosis, diabetes, skin pigmentation, cardiomyopathy and hypogonadism, and raises the risk of hepatocellular carcinoma.

Why is "Primary biliary cholangitis" not the answer?

Primary biliary cholangitis shows florid duct lesions and anti-mitochondrial antibodies.

Why is "Wilson disease" not the answer?

Wilson disease causes copper deposition, detected by rhodanine, with Kayser-Fleischer rings.

Why is "Alpha-1 antitrypsin deficiency" not the answer?

Alpha-1 antitrypsin deficiency shows PAS-positive, diastase-resistant globules.

What concept does this question test?

It tests Hepatic pathology: metabolic liver disease in Pathology. Perls Prussian blue stain identifies haemosiderin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatic pathology: metabolic liver disease?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.