{"id":36461,"date":"2026-04-05T11:52:20","date_gmt":"2026-04-05T06:22:20","guid":{"rendered":"https:\/\/atsixty.com\/?p=36461"},"modified":"2026-04-06T12:47:02","modified_gmt":"2026-04-06T07:17:02","slug":"liver-pathology-mcq","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/2026\/04\/05\/liver-pathology-mcq\/","title":{"rendered":"Liver Pathology MCQ"},"content":{"rendered":"\n<div id=\"atsixty-lvr-quiz\">\n<style>\n#atsixty-lvr-quiz {\n  --terra: #C0603A;\n  --terra-light: #d4795a;\n  --terra-pale: #fdf3ef;\n  --teal: #2A7A6F;\n  --teal-light: #3a9688;\n  --teal-pale: #eef6f5;\n  --ink: #1e1e1e;\n  --muted: #6b6b6b;\n  --rule: #e2d8d4;\n  --correct-bg: #e8f5e9;\n  --correct-border: #43a047;\n  --wrong-bg: #fdecea;\n  --wrong-border: #e53935;\n  --white: #fff;\n  --shadow: 0 2px 16px rgba(192,96,58,0.08);\n  font-family: Georgia, 'Times New Roman', serif;\n  color: var(--ink);\n  margin: 1rem 0 2rem;\n}\n#atsixty-lvr-quiz * { box-sizing: border-box; margin: 0; 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}\n#atsixty-lvr-quiz .submit-btn.visible { display: block; animation: lvrSlideUp 0.3s ease; }\n\n@keyframes lvrFadeIn  { from { opacity:0; transform:translateY(-4px); } to { opacity:1; transform:translateY(0); } }\n@keyframes lvrSlideUp { from { opacity:0; transform:translateX(-50%) translateY(12px); } to { opacity:1; transform:translateX(-50%) translateY(0); } }\n<\/style>\n\n<div class=\"quiz-shell\">\n  <div class=\"quiz-sentinel\" id=\"lvr-sentinel\"><\/div>\n\n  <div class=\"status-bar\" id=\"lvr-status-bar\">\n    <div class=\"progress-wrap\"><div class=\"progress-bar\" id=\"lvr-progress\"><\/div><\/div>\n    <div class=\"stats\">\n      <div class=\"stat-item\"><span class=\"dot dot-correct\"><\/span> \u2713 <strong id=\"lvr-sc\">0<\/strong><\/div>\n      <div class=\"stat-item\"><span class=\"dot dot-wrong\"><\/span> \u2717 <strong id=\"lvr-sw\">0<\/strong><\/div>\n      <div class=\"stat-item\"><span class=\"dot dot-rem\"><\/span> Left <strong id=\"lvr-sr\">15<\/strong><\/div>\n      <div class=\"sep\"><\/div>\n      <div class=\"stat-item\"><span class=\"dot dot-net\"><\/span> Net <strong id=\"lvr-sn\">0<\/strong><\/div>\n      <div class=\"stat-item\">Max <strong id=\"lvr-sm\">60<\/strong><\/div>\n    <\/div>\n  <\/div>\n\n  <div class=\"quiz-main\">\n    <div id=\"lvr-container\"><\/div>\n    <button class=\"submit-btn\" id=\"lvr-submit\">View Score \u2192<\/button>\n    <div class=\"score-panel\" id=\"lvr-score\"><\/div>\n  <\/div>\n<\/div>\n\n<script>\n(function () {\n\n  const Q = {\n    container : document.getElementById('lvr-container'),\n    submit    : document.getElementById('lvr-submit'),\n    score     : document.getElementById('lvr-score'),\n    progress  : document.getElementById('lvr-progress'),\n    sc: document.getElementById('lvr-sc'),\n    sw: document.getElementById('lvr-sw'),\n    sr: document.getElementById('lvr-sr'),\n    sn: document.getElementById('lvr-sn'),\n    sm: document.getElementById('lvr-sm')\n  };\n\n  const BANK = [\n    {\n      q: \"A 45-year-old man with chronic alcohol use presents with jaundice and tender hepatomegaly. Biopsy shows hepatocyte ballooning, Mallory-Denk bodies, and neutrophilic infiltration. Which of the following best describes the expected AST : ALT ratio?\",\n      correctAnswer: \"Greater than 2 : 1, with both enzymes rarely exceeding 300 IU\/L\",\n      opts: [\n        \"ALT markedly exceeds AST, often above 1000 IU\/L\",\n        \"Both AST and ALT are normal with raised GGT alone\",\n        \"AST and ALT are equal, both exceeding 2000 IU\/L\",\n        \"Greater than 2 : 1, with both enzymes rarely exceeding 300 IU\/L\"\n      ],\n      exp: \"<strong>Alcoholic hepatitis<\/strong>: AST : ALT ratio &gt;2 (classically \u22652:1) due to alcohol-induced mitochondrial injury depleting ALT and increasing mitochondrial AST. Absolute values rarely exceed 300 IU\/L \u2014 very high transaminases (&gt;1000) should prompt search for another cause (e.g., ischaemic hepatitis, acetaminophen toxicity). Mallory-Denk bodies = aggregates of cytokeratin 8\/18.\",\n      difficulty: \"medium\"\n    },\n    {\n      q: \"Which of the following statements regarding hepatitis B infection are correct?\\nI. HBsAg positivity for &gt;6 months defines chronicity\\nII. Anti-HBs appears during the window period\\nIII. HBeAg positivity indicates high infectivity\\nIV. Anti-HBc IgM is the earliest detectable antibody in acute infection\\n\\nSelect the correct answer:\",\n      correctAnswer: \"I, III, and IV\",\n      opts: [\n        \"I and II only\",\n        \"II and III only\",\n        \"I, III, and IV\",\n        \"II, III, and IV\"\n      ],\n      exp: \"<strong>HBV serology<\/strong>: HBsAg &gt;6 months = chronic (I \u2713). Anti-HBs appears <em>after<\/em> the window period \u2014 during the window only anti-HBc IgM is detectable (II \u2717). HBeAg = active viral replication, high infectivity (III \u2713). Anti-HBc IgM is the first antibody detectable in acute HBV (IV \u2713). Hence I, III, and IV are correct.\",\n      difficulty: \"medium\"\n    },\n    {\n      q: \"A 35-year-old woman presents with fatigue, elevated transaminases, and positive ANA and anti-smooth muscle antibody (ASMA). Serum IgG is markedly raised. The most likely diagnosis is:\",\n      correctAnswer: \"Autoimmune hepatitis\",\n      opts: [\n        \"Autoimmune hepatitis\",\n        \"Primary biliary cholangitis\",\n        \"Wilson disease\",\n        \"Drug-induced liver injury\"\n      ],\n      exp: \"<strong>Autoimmune hepatitis (AIH)<\/strong>: young to middle-aged women; positive ANA, ASMA (type 1) or anti-LKM1 (type 2); polyclonal IgG elevation; interface hepatitis on biopsy. PBC: anti-mitochondrial antibody (AMA-M2), cholestatic pattern, bile duct damage. Wilson: Kayser-Fleischer rings, low ceruloplasmin. AIH responds to corticosteroids.\",\n      difficulty: \"easy\"\n    },\n    {\n      q: \"On liver biopsy, 'ground-glass' hepatocytes on H&amp;E staining are characteristic of which condition?\",\n      correctAnswer: \"Chronic hepatitis B\",\n      opts: [\n        \"Alcoholic steatohepatitis\",\n        \"Hepatocellular carcinoma\",\n        \"Chronic hepatitis B\",\n        \"Primary sclerosing cholangitis\"\n      ],\n      exp: \"<strong>Ground-glass hepatocytes<\/strong>: smooth, pale eosinophilic cytoplasm packed with HBsAg-containing smooth ER \u2014 pathognomonic of chronic HBV. Confirmed by orcein or Victoria blue stain (stains HBsAg). Not seen in alcoholic hepatitis (Mallory-Denk bodies instead) or PSC (periductal 'onion-skin' fibrosis). Key NEET-PG histology point.\",\n      difficulty: \"easy\"\n    },\n    {\n      q: \"A 28-year-old presents with haemolytic anaemia, neuropsychiatric symptoms, and a serum ceruloplasmin of 12 mg\/dL (normal 20\u201360). Which histochemical stain is used to confirm copper accumulation in the liver biopsy?\",\n      correctAnswer: \"Rhodanine stain\",\n      opts: [\n        \"Prussian blue stain\",\n        \"PAS-diastase stain\",\n        \"Masson trichrome stain\",\n        \"Rhodanine stain\"\n      ],\n      exp: \"<strong>Wilson disease<\/strong>: autosomal recessive; ATP7B mutation \u2192 copper accumulation in liver, basal ganglia, cornea (Kayser-Fleischer rings). Rhodanine stain (or rubeanic acid) highlights hepatic copper. Prussian blue = iron (haemochromatosis). PAS-diastase = \u03b11-antitrypsin globules. Masson trichrome = fibrosis\/collagen.\",\n      difficulty: \"medium\"\n    },\n    {\n      q: \"A patient with long-standing ulcerative colitis develops progressive jaundice and pruritus. MRCP shows alternating strictures and dilatations ('beaded appearance') of both intra- and extra-hepatic bile ducts. The most likely diagnosis is:\",\n      correctAnswer: \"Primary sclerosing cholangitis\",\n      opts: [\n        \"Primary biliary cholangitis\",\n        \"Caroli disease\",\n        \"Choledocholithiasis\",\n        \"Primary sclerosing cholangitis\"\n      ],\n      exp: \"<strong>Primary sclerosing cholangitis (PSC)<\/strong>: strong association with IBD (especially UC, ~70% of PSC cases). MRCP: 'beaded' intra- and extra-hepatic ducts from multifocal strictures. Biopsy: periductal 'onion-skin' concentric fibrosis \u2192 biliary cirrhosis. Increased risk of cholangiocarcinoma. PBC affects intrahepatic small ducts only; AMA positive.\",\n      difficulty: \"easy\"\n    },\n    {\n      q: \"Consider the following regarding hepatocellular carcinoma (HCC):\\nI. Alpha-fetoprotein (AFP) is elevated in virtually all cases\\nII. It most commonly arises in a background of cirrhosis\\nIII. Arterial enhancement with venous washout on contrast CT is diagnostic\\nIV. It is the most common primary liver tumour worldwide\\n\\nWhich statements are correct?\",\n      correctAnswer: \"II, III, and IV\",\n      opts: [\n        \"I and II only\",\n        \"I, II, and III\",\n        \"I, III, and IV\",\n        \"II, III, and IV\"\n      ],\n      exp: \"<strong>HCC facts<\/strong>: AFP is elevated in only ~60\u201370% \u2014 not virtually all (I \u2717). Cirrhosis is the dominant risk factor; ~80\u201390% of HCC arises in cirrhotic livers (II \u2713). LI-RADS 5: arterial hyperenhancement + portal\/venous washout = HCC without biopsy (III \u2713). HCC is the most common primary liver malignancy globally, ranking #3 in cancer mortality (IV \u2713).\",\n      difficulty: \"hard\"\n    },\n    {\n      q: \"A 55-year-old man has serum ferritin of 1800 ng\/mL, transferrin saturation of 72%, and liver biopsy showing Perls' Prussian blue-positive iron deposits predominantly in hepatocytes (periportal). The most likely diagnosis is:\",\n      correctAnswer: \"Hereditary haemochromatosis\",\n      opts: [\n        \"Hereditary haemochromatosis\",\n        \"Secondary haemosiderosis from multiple transfusions\",\n        \"Alcoholic liver disease with siderosis\",\n        \"African iron overload\"\n      ],\n      exp: \"<strong>Hereditary haemochromatosis<\/strong>: HFE gene mutation (C282Y commonest); excess iron deposits in hepatocytes in a periportal (acinar zone 1) predominant pattern. Secondary siderosis (transfusion-related): iron in Kupffer cells first, then hepatocytes. Hepatic iron index (HIC\/age) &gt;1.9 supports hereditary form. Complications: cirrhosis, DM, cardiomyopathy, bronze skin \u2014 'bronze diabetes'.\",\n      difficulty: \"medium\"\n    },\n    {\n      q: \"A neonate presents with conjugated hyperbilirubinaemia, pale stools, and dark urine. HIDA scan shows no excretion into the gut. The most important immediate investigation to guide management is:\",\n      correctAnswer: \"Intraoperative cholangiogram\",\n      opts: [\n        \"Liver biopsy showing bile duct proliferation\",\n        \"Serum GGT level\",\n        \"Abdominal ultrasound for triangular cord sign\",\n        \"Intraoperative cholangiogram\"\n      ],\n      exp: \"<strong>Biliary atresia<\/strong>: presents in first 2 months; progressive obliteration of extrahepatic bile ducts. HIDA scan confirms obstruction. <strong>Intraoperative cholangiogram<\/strong> is the gold standard for definitive diagnosis and guides the Kasai portoenterostomy. Ultrasound (triangular cord sign) and liver biopsy (bile duct proliferation, plugs) are supportive. Kasai before 60 days = best outcomes.\",\n      difficulty: \"hard\"\n    },\n    {\n      q: \"A 40-year-old woman is incidentally found to have a well-defined, echogenic liver lesion on ultrasound. MRI shows peripheral nodular enhancement with centripetal fill-in on delayed sequences. The most likely diagnosis is:\",\n      correctAnswer: \"Cavernous haemangioma\",\n      opts: [\n        \"Focal nodular hyperplasia\",\n        \"Hepatocellular adenoma\",\n        \"Hepatic metastasis\",\n        \"Cavernous haemangioma\"\n      ],\n      exp: \"<strong>Hepatic cavernous haemangioma<\/strong>: most common benign liver tumour. Pathognomonic MRI: peripheral nodular arterial enhancement \u2192 progressive centripetal fill-in on delayed images ('light bulb' on T2). FNH: central scar with spoke-wheel vascularity on arterial phase. Adenoma: associated with OCP use, risk of rupture\/malignant transformation. Metastases: 'target' or ring enhancement.\",\n      difficulty: \"easy\"\n    },\n    {\n      q: \"Which zone of the hepatic acinus (Rappaport) is most vulnerable to ischaemic (hypoxic) injury?\",\n      correctAnswer: \"Zone 3 (centrilobular)\",\n      opts: [\n        \"Zone 1 (periportal)\",\n        \"Zone 2 (midzonal)\",\n        \"Zone 3 (centrilobular)\",\n        \"All zones are equally affected\"\n      ],\n      exp: \"<strong>Zone 3 (centrilobular)<\/strong> is farthest from the portal blood supply \u2192 lowest O\u2082 tension \u2192 most vulnerable to ischaemia (right heart failure, shock). Also most vulnerable to hepatotoxins (e.g., acetaminophen, CCl\u2084) requiring CYP450 activation. Zone 1 (periportal): most affected in phosphorus toxicity, eclampsia. Yellow fever: midzonal (zone 2) necrosis.\",\n      difficulty: \"medium\"\n    },\n    {\n      q: \"A 32-year-old woman on long-term oral contraceptives presents with sudden right upper quadrant pain and haemodynamic instability. CT shows a hypervascular liver mass with intraperitoneal haemorrhage. The most likely diagnosis is:\",\n      correctAnswer: \"Hepatocellular adenoma\",\n      opts: [\n        \"Hepatocellular carcinoma\",\n        \"Focal nodular hyperplasia\",\n        \"Hepatocellular adenoma\",\n        \"Angiosarcoma\"\n      ],\n      exp: \"<strong>Hepatocellular adenoma<\/strong>: benign, but associated with OCP, anabolic steroids, glycogen storage disease. Risk of spontaneous haemorrhage (life-threatening) and malignant transformation (~5% for &gt;5 cm). FNH rarely ruptures and has a central fibrous scar. HCC: background cirrhosis, elevated AFP. Angiosarcoma: associated with vinyl chloride, arsenic, Thorotrast exposure.\",\n      difficulty: \"medium\"\n    },\n    {\n      q: \"Which of the following is the most common site of metastasis to the liver among gastrointestinal primaries?\",\n      correctAnswer: \"Colorectal carcinoma\",\n      opts: [\n        \"Gastric carcinoma\",\n        \"Pancreatic carcinoma\",\n        \"Colorectal carcinoma\",\n        \"Oesophageal carcinoma\"\n      ],\n      exp: \"<strong>Colorectal carcinoma<\/strong> is the most common source of hepatic metastases overall. Portal venous drainage from the colon delivers tumour emboli to the liver as the first filter. Hepatic metastases are ~20\u00d7 more common than primary liver tumours in Western countries. Neuroendocrine tumours and uveal melanoma also have strong liver tropism. Key point: liver is the most common site of colorectal metastasis.\",\n      difficulty: \"easy\"\n    },\n    {\n      q: \"On histology of a cirrhotic liver, the hallmark architectural change that defines cirrhosis is:\",\n      correctAnswer: \"Diffuse nodular regeneration surrounded by fibrous septa\",\n      opts: [\n        \"Perivenular fibrosis confined to zone 3\",\n        \"Periportal fibrosis with preserved lobular architecture\",\n        \"Diffuse nodular regeneration surrounded by fibrous septa\",\n        \"Ductular reaction with copper accumulation\"\n      ],\n      exp: \"<strong>Cirrhosis<\/strong>: irreversible end-stage liver disease defined by three features \u2014 <strong>diffuse<\/strong> involvement, <strong>nodular regeneration<\/strong> of hepatocytes, and <strong>fibrous septa<\/strong> connecting portal tracts and central veins. Perivenular fibrosis alone = early alcoholic fibrosis (not cirrhosis). Periportal fibrosis = stage F2. Ductular reaction is a response to injury, not the defining lesion.\",\n      difficulty: \"easy\"\n    },\n    {\n      q: \"A patient presents with acute liver failure following ingestion of wild mushrooms. Liver biopsy shows massive centrilobular necrosis with sparing of periportal hepatocytes. The responsible toxin acts by:\",\n      correctAnswer: \"Inhibiting RNA polymerase II, blocking transcription\",\n      opts: [\n        \"Generating free radicals via CYP2E1, depleting glutathione\",\n        \"Inhibiting RNA polymerase II, blocking transcription\",\n        \"Directly alkylating mitochondrial DNA\",\n        \"Activating Fas-mediated hepatocyte apoptosis\"\n      ],\n      exp: \"<strong>Amanita phalloides<\/strong> (death cap): <em>\u03b1-amanitin<\/em> is the lethal toxin \u2014 it inhibits <strong>RNA polymerase II<\/strong>, blocking mRNA transcription \u2192 hepatocyte death. Causes massive (not centrilobular) necrosis. Note: acetaminophen toxicity (option A mechanism) causes centrilobular necrosis via CYP2E1-generated NAPQI depleting glutathione \u2014 a common NEET-PG distinction between the two toxins.\",\n      difficulty: \"hard\"\n    }\n  ];\n\n  function shuffle(arr) {\n    const a = [...arr];\n    for (let i = a.length - 1; i > 0; i--) {\n      const j = Math.floor(Math.random() * (i + 1));\n      [a[i], a[j]] = [a[j], a[i]];\n    }\n    return a;\n  }\n\n  let session = [], answered = [], total = 0;\n\n  function prepareSession() {\n    session = shuffle(BANK).map(q => {\n      const opts = shuffle(q.opts);\n      return { ...q, opts, ansIdx: opts.indexOf(q.correctAnswer) };\n    });\n    answered = new Array(session.length).fill(null);\n    total = 0;\n    Q.sn.textContent = '0';\n    Q.sm.textContent = session.length * 4;\n  }\n\n  function diffBadge(d) {\n    return d ? `<span class=\"diff diff-${d}\">${d}<\/span>` : '';\n  }\n\n  function buildQuiz() {\n    Q.container.innerHTML = '';\n    Q.sr.textContent = session.length;\n\n    session.forEach((q, i) => {\n      const card = document.createElement('div');\n      card.className = 'q-card';\n\n      const letters = ['A','B','C','D'];\n      const optsHTML = q.opts.map((opt, j) => `\n        <div class=\"opt\" id=\"lvr-o-${i}-${j}\">\n          <span class=\"opt-letter\">${letters[j]}<\/span>\n          <span>${opt}<\/span>\n        <\/div>`).join('');\n\n      const qText = q.q.replace(\/\\n\/g, '<br>');\n\n      card.innerHTML = `\n        <div class=\"q-head\">\n          <div class=\"q-num\" id=\"lvr-n-${i}\">${i + 1}<\/div>\n          <div class=\"q-text\">${qText}<\/div>\n        <\/div>\n        <div class=\"options\">${optsHTML}<\/div>\n        <div class=\"explanation\" id=\"lvr-e-${i}\">\n          <div class=\"exp-label\">Explanation ${diffBadge(q.difficulty)}<\/div>\n          ${q.exp}\n        <\/div>`;\n\n      Q.container.appendChild(card);\n      q.opts.forEach((_, j) => {\n        document.getElementById(`lvr-o-${i}-${j}`)\n          .addEventListener('click', () => answer(i, j));\n      });\n    });\n\n    Q.submit.classList.remove('visible');\n  }\n\n  function answer(qi, oi) {\n    if (answered[qi] !== null) return;\n    const q = session[qi];\n    const ok = oi === q.ansIdx;\n    answered[qi] = ok ? 'correct' : 'wrong';\n    total++;\n\n    q.opts.forEach((_, j) => {\n      const el = document.getElementById(`lvr-o-${qi}-${j}`);\n      if (j === q.ansIdx)       el.classList.add('correct');\n      else if (j === oi && !ok) el.classList.add('wrong');\n      else                      el.classList.add('dimmed');\n    });\n\n    document.getElementById(`lvr-e-${qi}`).classList.add('show');\n    document.getElementById(`lvr-n-${qi}`).classList.add(ok ? 'answered-c' : 'answered-w');\n\n    updateStats();\n    updateProgress();\n    if (total === session.length) Q.submit.classList.add('visible');\n  }\n\n  function updateStats() {\n    const c = answered.filter(a => a === 'correct').length;\n    const w = answered.filter(a => a === 'wrong').length;\n    const r = answered.filter(a => a === null).length;\n    const n = (c * 4) - w;\n    Q.sc.textContent = c;\n    Q.sw.textContent = w;\n    Q.sr.textContent = r;\n    Q.sn.textContent = n >= 0 ? '+' + n : n;\n    Q.sm.textContent = session.length * 4;\n  }\n\n  function updateProgress() {\n    Q.progress.style.width = (total \/ session.length * 100) + '%';\n  }\n\n  function showScore() {\n    const c  = answered.filter(a => a === 'correct').length;\n    const w  = answered.filter(a => a === 'wrong').length;\n    const sk = answered.filter(a => a === null).length;\n    const mx = session.length * 4;\n    const ns = (c * 4) - w;\n    const pc = Math.round((ns \/ mx) * 100);\n    const bw = Math.max(0, Math.min(100, pc));\n    const msg = pc >= 85 ? 'Outstanding! Strong command of liver pathology.' :\n                pc >= 65 ? 'Good foundation \u2014 revisit the explanations for the near misses.' :\n                pc >= 50 ? 'Reasonable base \u2014 one more active revision cycle will help.' :\n                pc >= 0  ? 'Targeted revision is advised before moving on.' :\n                           'Negative net score \u2014 in NEET-PG, blind guessing hurts.';\n\n    Q.score.innerHTML = `\n      <h2>Quiz Complete<\/h2>\n      <div class=\"score-num\">${ns < 0 ? ns : '+' + ns}<\/div>\n      <div class=\"score-denom\">Net Score &nbsp;|&nbsp; Max Marks: ${mx}<\/div>\n      <div class=\"grade-bar\"><div class=\"grade-fill\" style=\"width:${bw}%\"><\/div><\/div>\n      <div class=\"score-breakdown\">\n        <span><strong>${c}<\/strong><br>Correct<br><small>(+${c * 4})<\/small><\/span>\n        <span><strong>${w}<\/strong><br>Wrong<br><small>(\u2212${w})<\/small><\/span>\n        <span><strong>${sk}<\/strong><br>Skipped<br><small>(0)<\/small><\/span>\n        <span><strong>${Math.max(0, pc)}%<\/strong><br>Score%<\/span>\n      <\/div>\n      <div class=\"score-formula\">\n        Net = (${c} \u00d7 4) \u2212 ${w} = <strong>${ns}<\/strong>\n        &nbsp;|&nbsp; ${ns} \u00f7 ${mx} \u00d7 100 = <strong>${pc}%<\/strong>\n      <\/div>\n      <div class=\"score-msg\">${msg}<\/div>\n      <button class=\"btn-retry\" id=\"lvr-retry\">\u21ba Reshuffle &amp; Retry<\/button>`;\n\n    Q.score.style.display = 'block';\n    Q.submit.classList.remove('visible');\n    Q.score.scrollIntoView({ behavior: 'smooth' });\n    document.getElementById('lvr-retry').addEventListener('click', retryQuiz);\n  }\n\n  function retryQuiz() {\n    Q.score.style.display = 'none';\n    prepareSession();\n    updateStats();\n    updateProgress();\n    buildQuiz();\n    window.scrollTo({ top: 0, behavior: 'smooth' });\n  }\n\n  Q.submit.addEventListener('click', showScore);\n  prepareSession();\n  buildQuiz();\n  updateStats();\n\n  new IntersectionObserver(\n    ([e]) => document.getElementById('lvr-status-bar')\n                      .classList.toggle('visible', !e.isIntersecting),\n    { threshold: 0 }\n  ).observe(document.getElementById('lvr-sentinel'));\n\n})();\n<\/script>\n<\/div>\n\n\n<ul class=\"wp-block-latest-posts__list wp-block-latest-posts\"><li><a class=\"wp-block-latest-posts__post-title\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/08\/cms-2020-p1-part-4\/\">CMS 2020 P1 Part-4<\/a><\/li>\n<li><a class=\"wp-block-latest-posts__post-title\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/\">CMS 2020 P1 Part-3<\/a><\/li>\n<li><a class=\"wp-block-latest-posts__post-title\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-2\/\">CMS 2020 P1 Part-2<\/a><\/li>\n<li><a class=\"wp-block-latest-posts__post-title\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-1\/\">CMS 2020 P1 Part-1<\/a><\/li>\n<li><a class=\"wp-block-latest-posts__post-title\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/06\/gerd-oesophageal-disorders\/\">GERD Oesophageal Disorders<\/a><\/li>\n<\/ul>\n\n","protected":false},"excerpt":{"rendered":"<p>\u2713 0 \u2717 0 Left 15 Net 0 Max 60 View Score \u2192<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18,24],"tags":[],"class_list":["post-36461","post","type-post","status-publish","format-standard","hentry","category-cms","category-neet-pg"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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