Hepatitis C
Progression to cirrhosis is more common than with Hepatitis C infection
What our notes say
- Progression to cirrhosis is more common than with Hepatitis C infection (Medical MCQs: Chemical Pathology & Haematology Exam Review)
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- Topics tested: respiratory infections, tetanus, rheumatic fever, development milestones, dehydration, hepatitis C, congenital heart disease, Down syndrome, malnutrition, haemophilia, sickle cell disease, childhood cancers, breastfeeding, vaccination and the ECG. (Paediatrics end of fourth year main exam: 1 July 2019, Paper One, 99 of 100 MCQs)
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- A 54-year-old man has chronic hepatitis C infection with an elevated serum alanine aminotransferase. (Immunopathology complete mcqs — Past Paper Questions & Answers)
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Practice questions on Hepatitis C
NOT a way to contract Hepatitis C?
- Sharing needles
- Blood transfusion
- Sexual contact
- Eating food prepared by someone with Hepatitis C
- Shaking hands
Answer: D. HCV is not fecal-oral or foodborne. Shaking hands is also not a route, but option d is the intended distractor testing this common myth.
A 62-year-old male with chronic Hepatitis C and cirrhosis has a solitary liver mass. Which tumor marker, if >1000 ng/ml, is highly suggestive of HCC?
- CA 19-9
- CEA
- Alpha-fetoprotein (AFP)
- CA-125
Answer: C. Markedly elevated levels of Alpha-fetoprotein (AFP) are highly specific for HCC in the setting of chronic liver disease (though its sensitivity varies). ---
A 50-year-old female with a history of chronic hepatitis C develops ascites and esophageal varices. Liver biopsy shows micronodular cirrhosis. What is the most likely complication leading to this advanced liver disease?
- Hepatitis B co-infection
- Alcoholic liver disease
- Non-alcoholic fatty liver disease (NAFLD)
- Hepatocellular carcinoma
Answer: A. While chronic Hepatitis C is a direct cause of cirrhosis, co-infection with Hepatitis B can accelerate the progression to cirrhosis and hepatocellular carcinoma. In the context of already advanced disease, it's a significant factor that would have contributed to the severity and progression. ---
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?
- CA 19-9
- Carcinoembryonic Antigen (CEA)
- Alpha-fetoprotein (AFP)
- Cancer Antigen 125 (CA 125)
Answer: C. 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. ---
Which of the following primary liver malignancies is NOT typically associated with chronic Hepatitis B or Hepatitis C virus infection?
- Hepatocellular Carcinoma
- Fibrolamellar Hepatocellular Carcinoma
- Cholangiocarcinoma
- Hepatic Angiosarcoma
Answer: C. Cholangiocarcinoma is explicitly noted as not being associated with chronic Hepatitis B or C virus infection, unlike hepatocellular carcinoma and its variants. ---
A 54-year-old man with chronic hepatitis C develops a hepatocyte clone with loss of growth control and poor MHC class I expression. Which cell most likely destroys this abnormal clone?
- B lymphocyte
- CD4 lymphocyte
- CD8 lymphocyte
- NK cell
Answer: D. NK cells are programmed to destroy cells with poor or absent MHC class I expression. When a neoplastic or virally infected cell downregulates MHC I, NK cells recognize and kill it — a key mechanism of tumor immune surveillance.