Weekly Liver Histology and Physiology Exam - March 7, 2026 (Section A: MCQs) – 60 MCQs | Kenya

60 Weekly Exam: Liver Histology and Physiology exam questions on Weekly Liver Histology and Physiology Exam - March 7, 2026 (Section A: MCQs) for medical studen

This MCQ set contains 60 questions on Weekly Liver Histology and Physiology Exam - March 7, 2026 (Section A: MCQs) in the Weekly Exam: Liver Histology and Physiology unit. Each question includes the correct answer and a detailed explanation for active recall and exam preparation.

Q1: What is the structural unit of the liver characterized by a hexagonal shape with a central vein in the middle?

  1. A. Hepatic acinus
  2. B. Portal lobule
  3. C. Classical lobule
  4. D. Portal triad

Correct answer: C – Classical lobule

The classical lobule is hexagonal with a central vein at the center and portal triads at the periphery.

Q2: Which structure defines the functional unit of the liver based on microcirculation and metabolic gradients?

  1. A. Hepatic lobule
  2. B. Portal triad
  3. C. Kupffer cell
  4. D. Hepatic acinus

Correct answer: D – Hepatic acinus

The acinus is the functional unit of the liver, defined by the blood supply from the terminal branches of the portal vein and hepatic artery.

Q3: Which of the following is NOT a component of the portal triad?

  1. A. Bile duct
  2. B. Central vein
  3. C. Hepatic artery branch
  4. D. Portal vein branch

Correct answer: B – Central vein

The portal triad consists of a bile duct, a branch of the hepatic artery, and a branch of the portal vein. The central vein is at the center of the lobule.

Q4: Which zone of the hepatic acinus is most susceptible to ischemia/hypoxia?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Zone 4

Correct answer: C – Zone 3

Zone 3 (centrilobular) is the furthest from the arterial blood supply and is the first to be affected by hypoxia and ischemia.

Q5: Which zone of the liver acinus is the first to receive oxygenated blood from the hepatic artery?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Portal canal

Correct answer: A – Zone 1

Zone 1 (periportal) is the closest to the blood supply and receives the best oxygenation.

Q6: Phosphorus poisoning and eclampsia characteristically affect which area of the liver acinus first?

  1. A. Zone 3
  2. B. Zone 2
  3. C. Zone 1
  4. D. Central vein area

Correct answer: C – Zone 1

Zone 1 (periportal) is specifically affected by phosphorus poisoning and eclampsia.

Q7: The central vein of the hepatic lobule eventually drains into which vessel?

  1. A. Portal vein
  2. B. Hepatic vein
  3. C. Common bile duct
  4. D. Vena cava

Correct answer: B – Hepatic vein

Central veins are tributaries that eventually merge to form the hepatic veins.

Q8: In which zone does gluconeogenesis and oxidative metabolism primarily occur due to high oxygen availability?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Zone 4

Correct answer: A – Zone 1

Zone 1 (periportal) has the highest oxygen tension and is the site of high metabolic activity like gluconeogenesis.

Q9: Which cell type is responsible for the phagocytic activity within the liver sinusoids?

  1. A. Hepatocytes
  2. B. Stellate cells
  3. C. Kupffer cells
  4. D. Endothelial cells

Correct answer: C – Kupffer cells

Kupffer cells are resident macrophages located within the liver sinusoids.

Q10: The space of Disse is located between which two structures?

  1. A. Two hepatocytes
  2. B. Bile canaliculi and hepatocytes
  3. C. Sinusoidal endothelium and hepatocytes
  4. D. Central vein and portal triad

Correct answer: C – Sinusoidal endothelium and hepatocytes

The space of Disse (perisinusoidal space) lies between the sinusoidal endothelial cells and the hepatocytes.

Q11: Which hepatic cells are primarily involved in Vitamin A storage and myofibroblast transformation during fibrosis?

  1. A. Kupffer cells
  2. B. Ito cells (Stellate cells)
  3. C. Endothelial cells
  4. D. Pit cells

Correct answer: B – Ito cells (Stellate cells)

Ito cells (Stellate cells) store Vitamin A and, when activated, contribute to liver fibrosis by producing collagen.

Q12: Yellow fever and certain viral hepatitides frequently show maximal damage in which acinar zone?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Canalicular zone

Correct answer: B – Zone 2

Zone 2 (midzonal) is classically associated with the necrosis seen in Yellow fever.

Q13: A patient presents with toxic ingestion of Acetaminophen. Which zone of the liver is most likely to show necrosis?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Outer cortex

Correct answer: C – Zone 3

Acetaminophen toxicity causes centrilobular (Zone 3) necrosis because this zone contains the highest concentration of CYP450 enzymes.

Q14: What type of capillaries are found in the liver?

  1. A. Continuous
  2. B. Fenestrated
  3. C. Sinusoidal/Discontinuous
  4. D. Tight junction

Correct answer: C – Sinusoidal/Discontinuous

The liver contains sinusoidal (discontinuous) capillaries to allow for the exchange of large molecules between blood and hepatocytes.

Q15: Bile flows in which direction relative to blood flow in the lobule?

  1. A. Parallel and in the same direction
  2. B. Opposite direction (Centrifugal)
  3. C. Only in the central vein
  4. D. Does not flow in the lobule

Correct answer: B – Opposite direction (Centrifugal)

Blood flows from the portal triad toward the central vein (centripetal), while bile flows from the hepatocytes toward the portal triad (centrifugal).

Q16: Which zone is least susceptible to viral hepatitis but most susceptible to metabolic toxins?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Space of Mall

Correct answer: C – Zone 3

Zone 3 is highly susceptible to metabolic toxins (like CCl4) and ischemia, but less so to primary viral insults compared to Zone 1.

Q17: The portal triad is contained within a connective tissue sheath known as:

  1. A. Glisson's capsule
  2. B. Bowman's capsule
  3. C. Gerota's fascia
  4. D. Tenon's capsule

Correct answer: A – Glisson's capsule

Glisson's capsule is the connective tissue layer that covers the liver and extends into the portal tracts.

Q18: Drug metabolism via the Cytochrome P450 system is most active in which zone?

  1. A. Zone 1
  2. B. Zone 2
  3. C. Zone 3
  4. D. Zone 1 and 2 equally

Correct answer: C – Zone 3

Zone 3 has the highest concentration of P450 enzymes, making it a hotspot for drug metabolism and metabolite-induced injury.

Q19: Lymphatic fluid in the liver drains initially into which space before entering larger vessels?

  1. A. Space of Disse
  2. B. Space of Mall
  3. C. Canaliculi
  4. D. Sinusoid

Correct answer: B – Space of Mall

Fluid from the space of Disse flows into the space of Mall (at the edge of the portal canal) and then into lymphatic vessels.

Q20: A liver biopsy shows necrosis specifically around the central vein. This is described as:

  1. A. Periportal necrosis
  2. B. Midzonal necrosis
  3. C. Centrilobular necrosis
  4. D. Subcapsular necrosis

Correct answer: C – Centrilobular necrosis

Centrilobular necrosis refers to damage around the central vein, which corresponds to Zone 3.

Q21: Congestive heart failure leads to 'Nutmeg Liver' primarily through damage to which area?

  1. A. Zone 1
  2. B. Zone 3
  3. C. Zone 2
  4. D. Portal triad

Correct answer: B – Zone 3

Congestive heart failure causes hepatic venous congestion, affecting Zone 3 (the drainage area) most severely.

Q22: Hepatocytes are derived from which embryological layer?

  1. A. Ectoderm
  2. B. Mesoderm
  3. C. Endoderm
  4. D. Neural crest

Correct answer: C – Endoderm

Hepatocytes and the biliary tree lining are derived from the endoderm of the foregut.

Q23: In the context of the Portal Lobule model, what is at the center of the unit?

  1. A. Central vein
  2. B. Hepatic artery
  3. C. Portal triad
  4. D. Kupffer cell

Correct answer: C – Portal triad

In the portal lobule model (focused on bile drainage), the portal triad is the center, and the boundaries are central veins.

Q24: Which of the following is most likely to be high in Zone 1 hepatocytes?

  1. A. Concentration of Glycogen
  2. B. Sensitivity to ischemia
  3. C. Concentration of CYP450
  4. D. Amount of Carbon Tetrachloride damage

Correct answer: A – Concentration of Glycogen

Zone 1 (periportal) is active in glycogen synthesis and gluconeogenesis.

Q25: Bilirubin conjugation occurs within which part of the hepatocyte?

  1. A. Mitochondria
  2. B. Smooth Endoplasmic Reticulum
  3. C. Rough Endoplasmic Reticulum
  4. D. Lysosomes

Correct answer: B – Smooth Endoplasmic Reticulum

The conjugation of bilirubin by the enzyme UDP-glucuronosyltransferase occurs in the Smooth ER.

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