Anatomy and functions of liver MCQs With Answer

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Anatomy and functions of liver MCQs With Answer — This concise, student-focused introduction explains liver anatomy, microanatomy and core hepatic functions relevant to B. Pharm studies. It covers lobar and segmental anatomy, blood supply, hepatic sinusoids, hepatocytes, Kupffer and stellate cells, bile formation, metabolism of drugs, first-pass effect, protein synthesis, detoxification and clinical correlations like cirrhosis and drug-induced liver injury. Keywords such as liver anatomy, liver functions, hepatic metabolism, drug metabolism, and B. Pharm are integrated to support SEO and exam preparation. Clear, practical emphasis helps pharmacy students link structure to pharmacokinetics and therapeutics. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which vessel supplies approximately 75% of the liver’s blood volume?

  • Hepatic artery
  • Portal vein
  • Central vein
  • Hepatic vein

Correct Answer: Portal vein

Q2. The functional unit of the liver responsible for zonal metabolic specialization is called:

  • Hepatic lobule
  • Liver sinusoid
  • Portal triad
  • Glisson’s capsule

Correct Answer: Hepatic lobule

Q3. Which zone of the hepatic acinus is most susceptible to ischemic injury and lipid accumulation?

  • Zone 1 (periportal)
  • Zone 2 (midzonal)
  • Zone 3 (centrilobular)
  • Subcapsular zone

Correct Answer: Zone 3 (centrilobular)

Q4. Kupffer cells in the liver are primarily responsible for:

  • Bile secretion
  • Phagocytosis of pathogens and debris
  • Glycogen storage
  • Synthesis of clotting factors

Correct Answer: Phagocytosis of pathogens and debris

Q5. Which hepatic cell stores vitamin A and contributes to fibrosis when activated?

  • Hepatocyte
  • Kupffer cell
  • Stellate (Ito) cell
  • Endothelial cell

Correct Answer: Stellate (Ito) cell

Q6. Bile produced by hepatocytes first drains into:

  • Common bile duct
  • Gallbladder directly
  • Bile canaliculi
  • Hepatic vein

Correct Answer: Bile canaliculi

Q7. Which enzyme is a sensitive marker for hepatocellular injury and is highly relevant in drug toxicity assessment?

  • Alkaline phosphatase (ALP)
  • Gamma-glutamyl transferase (GGT)
  • Aspartate aminotransferase (AST)
  • Alanine aminotransferase (ALT)

Correct Answer: Alanine aminotransferase (ALT)

Q8. The first-pass effect primarily affects oral drugs by:

  • Increasing renal excretion
  • Causing presystemic hepatic metabolism
  • Preventing intestinal absorption
  • Enhancing protein binding in plasma

Correct Answer: Causing presystemic hepatic metabolism

Q9. Phase I reactions in hepatic drug metabolism commonly involve:

  • Conjugation with glucuronic acid
  • Hydrolysis and reduction mediated by cytochrome P450
  • Formation of sulfate conjugates
  • ATP-dependent transport into bile

Correct Answer: Hydrolysis and reduction mediated by cytochrome P450

Q10. Glucuronidation is classified as which type of metabolic reaction?

  • Phase I oxidation
  • Phase II conjugation
  • Phase I reduction
  • Phase III transport

Correct Answer: Phase II conjugation

Q11. Which protein synthesized by the liver maintains oncotic pressure and binds many drugs?

  • Transferrin
  • Albumin
  • Fibrinogen
  • C-reactive protein

Correct Answer: Albumin

Q12. Bilirubin conjugation occurs mainly in which hepatic structure?

  • Bile duct epithelium
  • Sinusoidal endothelial cells
  • Hepatocytes
  • Kupffer cells

Correct Answer: Hepatocytes

Q13. A rise in alkaline phosphatase with normal ALT suggests which pathology?

  • Hepatocellular necrosis
  • Cholestasis or biliary obstruction
  • Ischemic hepatitis
  • Acetaminophen toxicity

Correct Answer: Cholestasis or biliary obstruction

Q14. Which hepatic structure is the primary outflow for blood from the liver to systemic circulation?

  • Portal vein
  • Hepatic vein
  • Hepatic artery
  • Bile duct

Correct Answer: Hepatic vein

Q15. Fenestrated sinusoidal endothelium in the liver facilitates:

  • Active secretion of bile
  • Exchange between blood and hepatocytes
  • Storage of vitamin B12
  • Formation of bile canaliculi

Correct Answer: Exchange between blood and hepatocytes

Q16. Which hepatic factor enhances conjugation of bilirubin and drug metabolites?

  • UDP-glucuronosyltransferase (UGT)
  • CYP3A4 enzyme
  • Glycogen synthase
  • Glutamine synthetase

Correct Answer: UDP-glucuronosyltransferase (UGT)

Q17. Most synthetic clotting factors are produced by which cell type?

  • Hepatocytes
  • Kupffer cells
  • Pancreatic acinar cells
  • Endothelial cells

Correct Answer: Hepatocytes

Q18. Entrohepatic circulation mainly affects drugs by:

  • Increasing renal elimination
  • Prolonging drug half-life through biliary recycling
  • Preventing intestinal absorption
  • Enhancing hepatic uptake into mitochondria

Correct Answer: Prolonging drug half-life through biliary recycling

Q19. Which liver lobe is anatomically part of the right functional lobe but lies on the left side anatomically?

  • Caudate lobe
  • Quadrate lobe
  • Left lobe
  • Right lobe

Correct Answer: Quadrate lobe

Q20. In acetaminophen overdose, toxic metabolite formation occurs via:

  • Glucuronidation exclusively
  • CYP-mediated oxidation to NAPQI
  • Direct renal excretion
  • Sulfation only

Correct Answer: CYP-mediated oxidation to NAPQI

Q21. Hepatic clearance of a drug is most dependent on:

  • Only the fraction of drug excreted unchanged in urine
  • Hepatic blood flow, intrinsic clearance, and protein binding
  • Renal blood flow and glomerular filtration rate only
  • Volume of distribution only

Correct Answer: Hepatic blood flow, intrinsic clearance, and protein binding

Q22. Which enzyme induction in the liver can increase metabolism of many drugs leading to reduced efficacy?

  • CYP450 induction (e.g., CYP3A4)
  • UGT inhibition
  • Glutathione depletion
  • MAO-B activation

Correct Answer: CYP450 induction (e.g., CYP3A4)

Q23. Portal hypertension most directly results from pathology in which structure?

  • Portal vein pressure increase due to cirrhosis
  • Increased hepatic arterial flow
  • Obstruction of common bile duct
  • Renal vein thrombosis

Correct Answer: Portal vein pressure increase due to cirrhosis

Q24. Which substance is a major negative acute-phase protein synthesized by the liver?

  • C-reactive protein
  • Albumin
  • Haptoglobin
  • Fibrinogen

Correct Answer: Albumin

Q25. Hepatic microsomal enzyme system is primarily located in which organelle?

  • Mitochondria
  • Smooth endoplasmic reticulum
  • Golgi apparatus
  • Lysosomes

Correct Answer: Smooth endoplasmic reticulum

Q26. Which bile component is essential for lipid emulsification and absorption?

  • Albumin
  • Bile acids (bile salts)
  • Glucuronides
  • Bilirubin conjugates

Correct Answer: Bile acids (bile salts)

Q27. Hepatic encephalopathy in liver failure is primarily associated with accumulation of:

  • Urea
  • Ammonia
  • Insulin
  • Albumin

Correct Answer: Ammonia

Q28. Which anatomical structure contains the portal triad?

  • Hepatic lobule central area
  • Portal tract within portal triads at lobule periphery
  • Central vein
  • Gallbladder fossa

Correct Answer: Portal tract within portal triads at lobule periphery

Q29. A decrease in albumin synthesis affects drug pharmacokinetics by:

  • Reducing free drug fraction
  • Increasing free (unbound) drug leading to enhanced effect
  • Enhancing hepatic uptake of drugs
  • Lowering renal clearance directly

Correct Answer: Increasing free (unbound) drug leading to enhanced effect

Q30. Which test is most specific for cholestatic liver injury?

  • ALT elevation
  • AST elevation
  • Alkaline phosphatase (ALP) elevation
  • Lactate dehydrogenase increase

Correct Answer: Alkaline phosphatase (ALP) elevation

Q31. The porta hepatis contains all EXCEPT:

  • Portal vein
  • Hepatic artery
  • Common hepatic duct
  • Hepatic vein

Correct Answer: Hepatic vein

Q32. Which statement about hepatic regeneration is true?

  • Liver cannot regenerate after partial hepatectomy
  • Hepatocytes can re-enter cell cycle and restore mass
  • Only bile duct epithelium regenerates, hepatocytes do not
  • Regeneration requires stem cells from the bone marrow exclusively

Correct Answer: Hepatocytes can re-enter cell cycle and restore mass

Q33. Which transporter is important for hepatic uptake of many organic anions and drugs from blood?

  • P-glycoprotein (ABCB1)
  • OATP (organic anion transporting polypeptide)
  • GLUT2
  • Na+/K+ ATPase

Correct Answer: OATP (organic anion transporting polypeptide)

Q34. In cirrhosis, portal hypertension leads to formation of:

  • Nephrotic syndrome
  • Varices and splenomegaly
  • Hyperthyroidism
  • Lower limb edema only

Correct Answer: Varices and splenomegaly

Q35. Hepatocyte mitochondria are particularly important for:

  • Phase II conjugation
  • Beta-oxidation of fatty acids and energy production
  • Bile acid synthesis exclusively
  • Albumin secretion

Correct Answer: Beta-oxidation of fatty acids and energy production

Q36. Which condition increases risk of drug-induced liver injury due to reduced glutathione?

  • Excessive glucuronidation
  • Acetaminophen overdose
  • High albumin levels
  • Increased hepatic blood flow

Correct Answer: Acetaminophen overdose

Q37. The clinical test measuring conjugated and unconjugated bilirubin aids in diagnosing:

  • Renal tubular acidosis
  • Type of jaundice (hemolytic vs obstructive)
  • Pancreatic endocrine tumors
  • Hypothyroidism

Correct Answer: Type of jaundice (hemolytic vs obstructive)

Q38. Hepatic sinusoids differ from typical capillaries by having:

  • Tight continuous endothelium
  • Fenestrations and discontinuous basement membrane
  • Higher hydrostatic pressure than arteries
  • No immune cell presence

Correct Answer: Fenestrations and discontinuous basement membrane

Q39. Which is a major synthetic product of the liver involved in iron transport?

  • Transferrin
  • Ferritin
  • Haptoglobin
  • Albumin

Correct Answer: Transferrin

Q40. Drug interactions via displacement from albumin increase the:

  • Bound drug concentration only
  • Volume of distribution and free drug concentration temporarily
  • Elimination half-life uniformly for all drugs
  • Renal clearance only

Correct Answer: Volume of distribution and free drug concentration temporarily

Q41. Which hepatic enzyme induction is commonly associated with grapefruit juice interaction?

  • Induction of CYP3A4
  • Inhibition of CYP3A4
  • Activation of UGT enzymes
  • P-glycoprotein overexpression

Correct Answer: Inhibition of CYP3A4

Q42. The caudate lobe receives blood supply predominantly from:

  • Left lobe vessels only
  • Both right and left branches of the portal vein
  • Hepatic vein directly
  • Common hepatic artery only

Correct Answer: Both right and left branches of the portal vein

Q43. Which laboratory ratio suggests alcoholic liver disease more than viral hepatitis?

  • AST:ALT > 2
  • ALT:AST > 3
  • Normal AST and ALT with high bilirubin
  • Elevated ALP with normal transaminases

Correct Answer: AST:ALT > 2

Q44. Hepatocyte polarity is critical because apical membranes form:

  • Sinusoidal fenestrae
  • Bile canaliculi for bile secretion
  • Portal triads
  • Glisson’s capsule

Correct Answer: Bile canaliculi for bile secretion

Q45. Which process in the liver is central to maintaining blood glucose during fasting?

  • Glycogenesis only
  • Glycogenolysis and gluconeogenesis
  • Protein synthesis only
  • Lipid absorption

Correct Answer: Glycogenolysis and gluconeogenesis

Q46. Hepatobiliary excretion of drugs often involves:

  • Passive diffusion across central vein
  • Active transporters moving conjugated metabolites into bile
  • Secretion of unchanged drug into urine only
  • Endocytosis by Kupffer cells

Correct Answer: Active transporters moving conjugated metabolites into bile

Q47. Which vitamin is stored in significant amounts within hepatic stellate cells?

  • Vitamin C
  • Vitamin A
  • Vitamin K
  • Vitamin B12

Correct Answer: Vitamin A

Q48. Hepatic drug metabolism that produces reactive intermediates is most likely to cause:

  • Improved drug efficacy only
  • Tissue injury and idiosyncratic hepatotoxicity
  • Decreased half-life without toxicity
  • Reduced hepatic blood flow

Correct Answer: Tissue injury and idiosyncratic hepatotoxicity

Q49. Which factor increases hepatic clearance for a high-extraction ratio drug?

  • Decreased hepatic blood flow
  • Increased hepatic blood flow
  • Decreased fraction unbound in plasma
  • Reduced intrinsic clearance

Correct Answer: Increased hepatic blood flow

Q50. The term “functional liver unit” emphasizing blood supply from portal triads best describes the:

  • Portal acinus (acinus of Rappaport)
  • Hepatic capsule
  • Gallbladder mucosa
  • Renal lobule

Correct Answer: Portal acinus (acinus of Rappaport)

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