Practice 15 MCQs on MCQ: Ompath Study Home Blog Flashcards MCQs Dashboard Toggle the with OmpathStudy. Built for Kenyan medical and health students to revise...
Q1. A 45-year-old woman undergoes imaging for unrelated abdominal pain, revealing a 3 cm incidental liver lesion. Given its suspected diagnosis as the most common benign liver tumor, which of the following diagnostic procedures should be avoided?
Answer: Liver biopsy
Explanation: Cavernous hemangioma is the most common benign liver tumor. Biopsy is contraindicated due to the significant risk of hemorrhage associated with its vascular nature.
Q2. A 28-year-old woman on oral contraceptive pills presents to the emergency department with sudden onset severe right upper quadrant pain and hypovolemic shock. Imaging reveals a ruptured hepatic mass with significant intraabdominal hemorrhage. Which benign liver tumor is most likely responsible for her presentation?
Answer: Liver Cell Adenoma
Explanation: Liver cell adenoma is strongly associated with oral contraceptive use in young women and carries a significant risk of rupture leading to intraabdominal hemorrhage.
Q3. A liver lesion is identified in a 35-year-old asymptomatic male. Pathological examination of the resected specimen reveals a well-demarcated nodule characterized by a central stellate scar and radiating fibrous septa containing anomalous arteries and bile ductules. Which of the following is the most likely diagnosis?
Answer: Focal Nodular Hyperplasia
Explanation: The presence of a central stellate scar is the hallmark histological feature that characterizes Focal Nodular Hyperplasia (FNH).
Q4. Which of the following risk factors is most strongly associated with the development of Hepatocellular Carcinoma (HCC) globally?
Answer: Hemochromatosis
Explanation: Chronic Hepatitis B virus infection is the most significant global risk factor for HCC, increasing the risk by up to 200 times, especially in endemic areas.
Q5. A 62-year-old male with a history of chronic Hepatitis C and cirrhosis presents with new onset fatigue and weight loss. Imaging reveals a solitary liver mass. Which tumor marker, if significantly elevated ( 1000 ng/ml), would be highly suggestive of Hepatocellular Carcinoma?
Answer: Alpha-fetoprotein (AFP)
Explanation: Alpha-fetoprotein (AFP) levels greater than 1000 ng/ml are highly suggestive of Hepatocellular Carcinoma (HCC), especially in a patient with risk factors like chronic Hepatitis C and cirrhosis.
Q6. A 70-year-old man with a history of Primary Sclerosing Cholangitis (PSC) develops jaundice and an intrahepatic mass. His serum alpha-fetoprotein (AFP) level is within the normal range. Which primary liver malignancy is most consistent with this presentation?
Answer: Cholangiocarcinoma
Explanation: Cholangiocarcinoma is a bile duct origin tumor associated with PSC and is characterized by a normal AFP level, differentiating it from typical HCC.
Q7. A 58-year-old female presents with multiple bilateral liver lesions identified on CT scan. She has no known history of chronic liver disease or primary liver tumors. What is the most common diagnosis for malignant liver tumors in adults?
Answer: Metastatic Carcinoma
Explanation: Metastatic carcinoma (secondary liver cancer) is the most common hepatic malignancy overall, far outnumbering primary liver tumors.
Q8. A 2-year-old child presents with an enlarging abdomen and a palpable right upper quadrant mass. Biopsy reveals a malignant epithelial tumor with primitive mesenchymal stroma. Which liver tumor is most commonly seen in this pediatric age group?
Answer: Hepatoblastoma
Explanation: Hepatoblastoma is the most common primary malignant liver tumor of childhood, typically occurring in very young children.
Q9. Exposure to which of the following substances is a significant risk factor for developing hepatic Angiosarcoma?
Answer: Vinyl chloride
Explanation: Hepatic Angiosarcoma is a rare but highly aggressive liver tumor strongly associated with exposure to certain environmental toxins like vinyl chloride, arsenic, and Thorotrast.
Q10. Regarding Hepatocellular Carcinoma (HCC), which statement is correct concerning its variant forms?
Answer: The fibrolamellar variant often presents with a normal alpha-fetoprotein level and a better prognosis.
Explanation: The fibrolamellar variant of HCC generally occurs in younger, otherwise healthy individuals, often presents with normal AFP, and has a better prognosis compared to conventional HCC.
Q11. A 30-year-old female, who has been taking oral contraceptives for 10 years, develops an asymptomatic liver lesion. Imaging shows a 5 cm solitary, encapsulated mass. Which of the following differentiates this tumor from Focal Nodular Hyperplasia (FNH)?
Answer: Regression upon discontinuation of oral contraceptives.
Explanation: Liver cell adenomas are strongly linked to OCPs and regress upon their cessation, a key differentiator from FNH which is not hormone-related and lacks this regression.
Q12. A 65-year-old male with a long history of heavy alcohol use and cirrhosis presents with weight loss and an abdominal mass. His AFP level is 1500 ng/ml. Which primary liver tumor is most likely, and what characteristic differentiates it from Cholangiocarcinoma in this context?
Answer: Hepatocellular Carcinoma; significantly elevated AFP and association with cirrhosis.
Explanation: Hepatocellular Carcinoma (HCC) is highly associated with cirrhosis from alcohol and presents with significantly elevated AFP. Cholangiocarcinoma is typically associated with normal AFP and different risk factors like PSC.
Q13. A 72-year-old patient undergoes a CT scan which reveals multiple, often ill-defined, hypodense lesions throughout both lobes of the liver. The patient has a known history of colorectal cancer diagnosed 2 years prior. What is the most probable origin of these liver lesions?
Answer: Metastatic disease from colorectal primary
Explanation: The most common source of metastatic liver disease is colorectal cancer, and multiple lesions throughout the liver are highly characteristic of metastasis rather than a primary tumor.
Q14. Which of the following primary liver malignancies is NOT typically associated with chronic Hepatitis B or Hepatitis C virus infection?
Answer: Cholangiocarcinoma
Explanation: Cholangiocarcinoma is explicitly noted as not being associated with chronic Hepatitis B or C virus infection, unlike hepatocellular carcinoma and its variants.
Q15. A patient diagnosed with a benign liver lesion is advised against biopsy due to the significant risk of hemorrhage. This contraindication is most characteristic of which benign liver tumor?
Answer: Cavernous Hemangioma
Explanation: Cavernous hemangiomas are highly vascular lesions, and performing a biopsy carries a substantial risk of severe, potentially life-threatening hemorrhage.