This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T, Subject name: Pathology
Centrilobular necrosis of liver may be seen with 
Select and explain. 
A. Phosphorus, B. Arsenic, C. ccI4, D. Ethanol
C: ccI4
Answer: C: ccI4 
Explanation: CCl4 is hepatotoxic. Centrilobular necrosis seen in CVC liver. Causes: right sided hea failure. Mechanism: dilatation of central veins-Transmission of increased venous pressure to the sinusoids-dilatation of sinusoids-ischemic necrosis of hepatocytes in centrilobular region. Gross: congested centrilobular area appear dark red brown, peripoal region is better oxygenated hence appear pale Microscopy: centrilobular region: congestion, hemorrhage, thickening of Central veins and fibrosis, centrilobular hepatocyte necrosis. Peripoal region: fatty change in hepatocytes. GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.89