Question 1

A patient presents with acute liver failure after a paracetamol overdose. Histological examination reveals centrilobular necrosis. Which zone of the liver acinus is most affected in this scenario?

Accepted Answer

Zone 3 (centrilobular)

Question 2

Which of the following best describes the direction of bile flow in relation to blood flow within the hepatic lobule?

Accepted Answer

Bile flows from the central vein toward the portal triad, opposite to blood flow.

Question 3

A liver biopsy stained with Perls' Prussian Blue reveals blue granules within hepatocytes. What is the most likely diagnosis?

Accepted Answer

Haemochromatosis (iron overload)

Question 4

Which cell type is responsible for storing vitamin A in the healthy liver and contributes to fibrosis when activated?

Accepted Answer

Hepatic stellate (Ito) cells

Question 5

A patient with chronic hepatitis C develops cirrhosis. Which TWO histological features are required for a definitive diagnosis of cirrhosis?

Accepted Answer

Thick bands of mature fibrous tissue and nodules of regenerative hepatocytes

Question 6

Which of the following stains is most appropriate for identifying amyloid deposits in a kidney biopsy, and what is the characteristic appearance under polarized light?

Accepted Answer

Congo Red; apple-green birefringence

Question 7

A renal biopsy shows thickened glomerular basement membranes with 'spikes' visible on silver stain. Which disease is most likely?

Accepted Answer

Membranous nephropathy

Question 8

Which of the following best describes the three layers of the glomerular filtration barrier in the kidney?

Accepted Answer

Fenestrated endothelium, glomerular basement membrane, podocyte filtration slits

Question 9

A 45-year-old man with a history of alcohol abuse presents with a shrunken, nodular liver. Which special stain would best highlight the thick bands of collagen seen in his liver biopsy?

Accepted Answer

Masson Trichrome

Question 10

Which of the following statements about the portal triad is CORRECT?

Accepted Answer

It contains the portal vein, hepatic artery, bile duct, and lymphatic vessel.

Question 11

A patient with nephrotic syndrome is found to have proteinuria. Which component of the glomerular filtration barrier is most likely damaged?

Accepted Answer

Podocyte filtration slits

Question 12

Which of the following best explains why the liver is the most common site for secondary (metastatic) tumors from the gastrointestinal tract?

Accepted Answer

The liver receives blood from the GI tract via the portal vein.

Question 13

Which of the following is TRUE regarding the function and location of the macula densa in the kidney?

Accepted Answer

It senses sodium concentration in the distal convoluted tubule and signals juxtaglomerular cells to release renin.

Question 14

A kidney biopsy is stained with PAS and shows a thickened, uneven basement membrane. What is the most likely underlying process?

Accepted Answer

Glomerulonephritis

Question 15

Which of the following best describes the histological difference between the proximal convoluted tubule (PCT) and distal convoluted tubule (DCT) in the kidney?

Accepted Answer

PCT has a narrow lumen with a prominent brush border; DCT has a wide lumen and pale cytoplasm.

Question 16

A patient with repeated blood transfusions develops iron overload. Iron is found mainly in Kupffer cells. What is the correct term for this condition?

Accepted Answer

Haemosiderosis

Question 17

Which of the following best describes the role of juxtaglomerular (JG) cells in the kidney?

Accepted Answer

They secrete renin in response to low blood pressure or low sodium.

Question 18

Which of the following stains requires a frozen section and is used to identify fat droplets in a liver biopsy?

Accepted Answer

Oil Red O

Question 19

A 60-year-old man with chronic hepatitis B develops a primary liver tumor. Which of the following statements is most accurate?

Accepted Answer

He is at increased risk for hepatocellular carcinoma, especially if he has cirrhosis.

Question 20

Which of the following best describes the location of arcuate arteries in the kidney and their significance in histology?

Accepted Answer

They are found at the corticomedullary junction and serve as a landmark for distinguishing cortex from medulla.

Liver and Kidney: Histology, Pathology, and Special Stains – Exam-Ready Study Notes

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