Haemodynamics: Budd-Chiari 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 · Haemodynamics: Budd-Chiari syndrome

Sample item

A young woman with polycythaemia vera develops painful hepatomegaly, ascites and rapid weight gain. Imaging shows non-visualisation of the hepatic veins. What does liver histology show?

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

The answer and the reasoning

A. Centrilobular congestion and necrosis

Hepatic vein outflow obstruction in Budd-Chiari syndrome causes centrilobular congestion, haemorrhage and necrosis, later leading to fibrosis. Myeloproliferative neoplasms and thrombophilias are common causes.

Option by option

  • A. Centrilobular congestion and necrosis (correct)

    Correct. Blocked hepatic outflow leads to centrilobular congestion and necrosis.

  • B. Periportal piecemeal necrosis

    Periportal piecemeal necrosis is seen in chronic autoimmune or viral hepatitis.

  • C. Macrovesicular steatosis

    Macrovesicular steatosis is typical of alcoholic or metabolic liver disease.

  • D. Granulomas around bile ducts

    Granulomas around bile ducts suggest primary biliary cholangitis.

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, Centrilobular congestion and necrosis. Hepatic vein outflow obstruction in Budd-Chiari syndrome causes centrilobular congestion, haemorrhage and necrosis, later leading to fibrosis.

Why is "Periportal piecemeal necrosis" not the answer?

Periportal piecemeal necrosis is seen in chronic autoimmune or viral hepatitis.

Why is "Macrovesicular steatosis" not the answer?

Macrovesicular steatosis is typical of alcoholic or metabolic liver disease.

Why is "Granulomas around bile ducts" not the answer?

Granulomas around bile ducts suggest primary biliary cholangitis.

What concept does this question test?

It tests Haemodynamics: Budd-Chiari syndrome in Pathology. Myeloproliferative neoplasms and thrombophilias are common causes.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Haemodynamics: Budd-Chiari 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.