Systemic pathology: Reye syndrome: 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 · Systemic pathology: Reye syndrome

Sample item

A 6-year-old child given aspirin for influenza develops persistent vomiting and then confusion and seizures, with raised ammonia and transaminases and no jaundice. What is the expected finding on liver biopsy?

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

The answer and the reasoning

B. Microvesicular steatosis without significant inflammation

Reye syndrome causes acute encephalopathy and liver failure with diffuse microvesicular fatty change from mitochondrial injury. The brain shows cerebral oedema, and the link with aspirin use in viral infection led to avoidance in children.

Option by option

  • A. Bile plugs with portal neutrophils

    Bile plugs and portal neutrophils indicate cholestasis or ascending cholangitis.

  • B. Microvesicular steatosis without significant inflammation (correct)

    Correct. Diffuse small fat droplets from mitochondrial injury occur with little inflammation.

  • C. Macrovesicular steatosis with Mallory-Denk bodies

    Macrovesicular fat with Mallory-Denk bodies characterises alcoholic or metabolic steatohepatitis.

  • D. Massive confluent necrosis

    Massive necrosis suggests fulminant viral hepatitis or drug toxicity, with jaundice.

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 B, Microvesicular steatosis without significant inflammation. Reye syndrome causes acute encephalopathy and liver failure with diffuse microvesicular fatty change from mitochondrial injury.

Why is "Bile plugs with portal neutrophils" not the answer?

Bile plugs and portal neutrophils indicate cholestasis or ascending cholangitis.

Why is "Macrovesicular steatosis with Mallory-Denk bodies" not the answer?

Macrovesicular fat with Mallory-Denk bodies characterises alcoholic or metabolic steatohepatitis.

Why is "Massive confluent necrosis" not the answer?

Massive necrosis suggests fulminant viral hepatitis or drug toxicity, with jaundice.

What concept does this question test?

It tests Systemic pathology: Reye syndrome in Pathology. The brain shows cerebral oedema, and the link with aspirin use in viral infection led to avoidance 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 Systemic pathology: Reye syndrome?

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.