Tissue repair: hepatic fibrosis: practice question

A Pathology 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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Pathology · Tissue repair: hepatic fibrosis

Sample item

A 45-year-old man with 15 years of chronic hepatitis C has a liver biopsy showing bridging fibrosis. Which cell is the main source of the excess collagen, and what is its principal activating signal?

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

The answer and the reasoning

C. Hepatic stellate cell activated by TGF-beta and PDGF

Perisinusoidal stellate (Ito) cells normally store vitamin A. After injury, cytokines such as TGF-beta and PDGF from Kupffer cells and damaged hepatocytes turn them into myofibroblast-like cells that lay down type I and III collagen. Persistent activation produces septal fibrosis and eventually cirrhosis.

Option by option

  • A. Sinusoidal endothelial cell stimulated by VEGF

    VEGF acts on endothelium to promote angiogenesis and is not the trigger of matrix production.

  • B. Hepatocyte undergoing mesenchymal change under HGF

    HGF drives hepatocyte proliferation in regeneration and does not turn hepatocytes into collagen producers.

  • C. Hepatic stellate cell activated by TGF-beta and PDGF (correct)

    Activated stellate cells are the principal collagen-producing cells in hepatic fibrosis.

  • D. Kupffer cell converted to a fibroblast by IL-2

    Kupffer cells release the signals but do not transform into collagen-producing fibroblasts under IL-2.

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 Pathology question

What is the answer to this Pathology question?

The best answer is C, Hepatic stellate cell activated by TGF-beta and PDGF. Perisinusoidal stellate (Ito) cells normally store vitamin A.

Why is "Sinusoidal endothelial cell stimulated by VEGF" not the answer?

VEGF acts on endothelium to promote angiogenesis and is not the trigger of matrix production.

Why is "Hepatocyte undergoing mesenchymal change under HGF" not the answer?

HGF drives hepatocyte proliferation in regeneration and does not turn hepatocytes into collagen producers.

Why is "Kupffer cell converted to a fibroblast by IL-2" not the answer?

Kupffer cells release the signals but do not transform into collagen-producing fibroblasts under IL-2.

What concept does this question test?

It tests Tissue repair: hepatic fibrosis in Pathology. After injury, cytokines such as TGF-beta and PDGF from Kupffer cells and damaged hepatocytes turn them into myofibroblast-like cells that lay down type I and III collagen. Persistent activation produces septal fibrosis and eventually cirrhosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Tissue repair: hepatic fibrosis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.