Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissue: 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: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissue

Sample item

On day 12 after bone marrow transplant with busulfan and cyclophosphamide conditioning, a patient has weight gain, painful hepatomegaly and bilirubin of 6 mg/dL. What is the mechanism?

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

The answer and the reasoning

B. Injury to sinusoidal endothelium with sinusoidal occlusion

Sinusoidal obstruction syndrome follows conditioning chemotherapy. Endothelial injury leads to sinusoidal and terminal venule occlusion, causing painful hepatomegaly, weight gain from ascites and jaundice.

Option by option

  • A. Donor T cell attack on bile ducts

    Donor T cell attack on bile ducts is graft-versus-host disease, usually with rash and diarrhoea.

  • B. Injury to sinusoidal endothelium with sinusoidal occlusion (correct)

    Correct. Chemotherapy-induced endothelial damage with sinusoidal occlusion explains this syndrome.

  • C. Thrombosis of the main hepatic veins

    Main hepatic vein thrombosis is Budd-Chiari syndrome, with a thrombophilic cause.

  • D. Reactivation of hepatitis B

    Hepatitis B reactivation causes hepatocellular necrosis with markedly raised transaminases.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Injury to sinusoidal endothelium with sinusoidal occlusion. Sinusoidal obstruction syndrome follows conditioning chemotherapy.

Why is "Donor T cell attack on bile ducts" not the answer?

Donor T cell attack on bile ducts is graft-versus-host disease, usually with rash and diarrhoea.

Why is "Thrombosis of the main hepatic veins" not the answer?

Main hepatic vein thrombosis is Budd-Chiari syndrome, with a thrombophilic cause.

Why is "Reactivation of hepatitis B" not the answer?

Hepatitis B reactivation causes hepatocellular necrosis with markedly raised transaminases.

What concept does this question test?

It tests Systemic pathology: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissue in Pathology. Endothelial injury leads to sinusoidal and terminal venule occlusion, causing painful hepatomegaly, weight gain from ascites and jaundice.

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: cardiovascular, respiratory, GI, renal, endocrine, CNS, bone and soft tissue?

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.