Virology: Reye syndrome: practice question

A Microbiology 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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Microbiology · Virology: Reye syndrome

Sample item

A 7-year-old child recovering from influenza B and treated with aspirin develops persistent vomiting, then confusion and seizures. Blood glucose is low, ammonia and transaminases are raised, and bilirubin is near normal. Which liver biopsy finding is expected?

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

The answer and the reasoning

C. Microvesicular fatty change with mitochondrial injury

Reye syndrome is an acute encephalopathy with fatty liver that follows viral infections such as influenza or varicella in children given salicylates. Mitochondrial dysfunction impairs beta-oxidation and ureagenesis, giving hypoglycaemia, hyperammonaemia and microvesicular steatosis. Aspirin should be avoided in febrile viral illness in children.

Option by option

  • A. Macrovesicular steatosis with Mallory hyaline

    Macrovesicular steatosis with Mallory hyaline is typical of alcoholic hepatitis.

  • B. Periportal fibrosis with bile duct proliferation

    Periportal fibrosis with ductular proliferation suggests chronic biliary disease and not an acute illness.

  • C. Microvesicular fatty change with mitochondrial injury (correct)

    Microvesicular steatosis from mitochondrial injury is the characteristic histology.

  • D. Councilman bodies with lobular inflammation

    Councilman bodies indicate apoptotic hepatocytes in viral hepatitis and the inflammatory picture is absent here.

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 Microbiology question

What is the answer to this Microbiology question?

The best answer is C, Microvesicular fatty change with mitochondrial injury. Reye syndrome is an acute encephalopathy with fatty liver that follows viral infections such as influenza or varicella in children given salicylates.

Why is "Macrovesicular steatosis with Mallory hyaline" not the answer?

Macrovesicular steatosis with Mallory hyaline is typical of alcoholic hepatitis.

Why is "Periportal fibrosis with bile duct proliferation" not the answer?

Periportal fibrosis with ductular proliferation suggests chronic biliary disease and not an acute illness.

Why is "Councilman bodies with lobular inflammation" not the answer?

Councilman bodies indicate apoptotic hepatocytes in viral hepatitis and the inflammatory picture is absent here.

What concept does this question test?

It tests Virology: Reye syndrome in Microbiology. Mitochondrial dysfunction impairs beta-oxidation and ureagenesis, giving hypoglycaemia, hyperammonaemia and microvesicular steatosis. Aspirin should be avoided in febrile viral illness in children.

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 Virology: Reye syndrome?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology 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.