Radiotherapy and nuclear medicine basics: radiation-induced liver disease: practice question

A Radiology 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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Radiology · Radiotherapy and nuclear medicine basics: radiation-induced liver disease

Sample item

Four to eight weeks after external beam radiation to the right hepatic lobe, a patient has anicteric hepatomegaly, ascites and a markedly raised alkaline phosphatase. What is the diagnosis?

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

The answer and the reasoning

C. Radiation-induced liver disease

Classic radiation-induced liver disease appears weeks after irradiation with painless anicteric hepatomegaly, ascites and a disproportionately raised alkaline phosphatase, caused by veno-occlusive change in central veins. An abscess causes fever and pain, recurrence presents with a mass, and portal vein thrombosis shows a filling defect.

Option by option

  • A. Portal vein thrombosis

    Portal vein thrombosis shows an intraluminal thrombus on Doppler or CT.

  • B. Hepatic abscess

    A hepatic abscess presents with fever and a focal collection.

  • C. Radiation-induced liver disease (correct)

    Correct. The anicteric hepatomegaly with ascites and raised ALP is radiation-induced liver disease.

  • D. Recurrent hepatocellular carcinoma

    Recurrent tumour presents with a mass rather than diffuse hepatomegaly.

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 Radiology question

What is the answer to this Radiology question?

The best answer is C, Radiation-induced liver disease. Classic radiation-induced liver disease appears weeks after irradiation with painless anicteric hepatomegaly, ascites and a disproportionately raised alkaline phosphatase, caused by veno-occlusive change in central veins.

Why is "Portal vein thrombosis" not the answer?

Portal vein thrombosis shows an intraluminal thrombus on Doppler or CT.

Why is "Hepatic abscess" not the answer?

A hepatic abscess presents with fever and a focal collection.

Why is "Recurrent hepatocellular carcinoma" not the answer?

Recurrent tumour presents with a mass rather than diffuse hepatomegaly.

What concept does this question test?

It tests Radiotherapy and nuclear medicine basics: radiation-induced liver disease in Radiology. An abscess causes fever and pain, recurrence presents with a mass, and portal vein thrombosis shows a filling defect.

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 Radiotherapy and nuclear medicine basics: radiation-induced liver disease?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.