ROSH Gastrointestinal Practice Exam

What is the most common cause of cirrhosis in the United States?

1. Alcoholic liver disease

2. Autoimmune hepatitis

3. Hepatitis A

4. Primary sclerosing cholangitis

The correct answer is: Alcoholic liver disease

Alcoholic liver disease stands out as the most common cause of cirrhosis in the United States. This condition arises from prolonged and excessive alcohol consumption, which leads to inflammation and damage of liver cells, eventually resulting in fibrosis and cirrhosis. The progression from alcoholic liver disease to cirrhosis is typically a gradual process. Chronic alcohol abuse causes the liver to attempt to repair itself, but repeated injury and inflammation can lead to scarring, impairing liver function. This is particularly significant in the U.S., where alcohol consumption patterns have contributed to higher rates of liver damage. Other conditions listed, such as autoimmune hepatitis, hepatitis A, and primary sclerosing cholangitis, do contribute to liver disease but are far less prevalent as causes of cirrhosis in the general population compared to alcoholic liver disease. Autoimmune hepatitis is an immune-mediated liver condition that occurs less frequently, while hepatitis A typically leads to acute liver inflammation rather than chronic liver disease. Primary sclerosing cholangitis primarily affects the bile ducts and is more commonly associated with inflammatory bowel disease, making it a less frequent cause of cirrhosis overall.