Which adverse effects are associated with systemic corticosteroid therapy?

Which adverse effects are associated with systemic corticosteroid therapy?

• A. Hypertension and hyperkalemia only.
• B. Avascular necrosis of bone, osteoporosis, and tendinopathies.
• C. Liver failure and ascites.
• D. Hypothyroidism.

Answer: (B)

Systemic corticosteroids commonly affect bone and connective tissues, so bone and tendon complications are classic adverse effects. Long-term or high-dose therapy reduces bone formation and increases bone resorption, leading to osteoporosis with fracture risk, especially vertebral and hip fractures. They also raise the risk of avascular necrosis, particularly of the femoral head, due to disrupted blood supply and fat emboli-like changes within bone vessels. In addition, these drugs can weaken tendons by impairing collagen synthesis and tenocyte function, increasing the risk of tendinopathy and even rupture. Other choices don’t fit as well: while steroids can contribute to hypertension, hyperkalemia is not a typical or expected effect (mineralocorticoid activity often causes potassium loss, i.e., hypokalemia). Liver failure and ascites, and hypothyroidism are not standard, characteristic adverse effects of systemic corticosteroid therapy.

Systemic corticosteroids commonly affect bone and connective tissues, so bone and tendon complications are classic adverse effects. Long-term or high-dose therapy reduces bone formation and increases bone resorption, leading to osteoporosis with fracture risk, especially vertebral and hip fractures. They also raise the risk of avascular necrosis, particularly of the femoral head, due to disrupted blood supply and fat emboli-like changes within bone vessels. In addition, these drugs can weaken tendons by impairing collagen synthesis and tenocyte function, increasing the risk of tendinopathy and even rupture.

Other choices don’t fit as well: while steroids can contribute to hypertension, hyperkalemia is not a typical or expected effect (mineralocorticoid activity often causes potassium loss, i.e., hypokalemia). Liver failure and ascites, and hypothyroidism are not standard, characteristic adverse effects of systemic corticosteroid therapy.