This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
[{'content': 'Regarding Chronic Viral Hepatitis - \nSelect and explain. \nA. Hepatitis A virus infection is a common cause in children, B. Morphological classification into Chronic Active Hepatitis and Chronic Persistent Hepatitis are important, C. Fatty change is pathognomic of Hepatitis C virus infection, D. Grading refers to the extent of necrosis and inflammations', 'role': 'user'}, {'content': "Answer: D \nExplanation: Classification of hepatitis\n\nIn the new classification system of Hepatitis, Grading refers to the assessment of necroinflammatory activity.\nChronic hepatitis represents a series of liver disorders of varying causes and severity in which hepatic inflammation and necrosis continue for at least 6 months.\nEarlier chronic hepatitis was categorized into three types depending upon histopathological features. These are\n\n\nChronic persistent hepatitis\nChronic lobular hepatitis\nChronic active hepatitis\n\n\nNow, this categorization has been replaced by more informative classification based upon a combination of clinical serological and histological variables.\nNow the classification is based upon —\n\n\nIt's cause\nIts histologic activity or grade\nIt's a degree of progression or stage\n\n(a) Classification by cause —\n\nIn this, the hepatitis is classified according to the cause - such as viral hepatitis, autoimmune hepatitis, drug-associated hepatitis.\n\n(b) Classification by Grade —\n\nThis classification is based upon an assessment of necroinflammatory activity.\nAn assessment of following histological features is made on liver biopsy -\nPeriportal necrosis\nPiecemeal necrosis\nBridging necrosis\nPortal inflammation\n\n(c) Classification by stage —\n\nThis classification is based upon the degree of fibrosis.\nIt reflects the levels of progression of the disease.\nStaging is based upon the degree of fibrosis as follows\n\n0 = No fibrosis\n1= Mild fibrosis (limited to portal tract)\n2 = Moderate fibrosis (Portal and periportal fibrosis)\n3 = Severe fibrosis including bridging fibrosis\n4 = Cirrhosis", 'role': 'assistant'}]