Endocrinology: pioglitazone adverse effects: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Endocrinology: pioglitazone adverse effects

Sample item

A diabetic patient with NYHA class III heart failure is on pioglitazone. What is the main concern?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Fluid retention precipitating heart failure, with fracture and bladder cancer risks

Thiazolidinediones activate PPAR-gamma and cause sodium and water retention, so they are contraindicated in NYHA III-IV heart failure. Other adverse effects are weight gain, fractures and an increased risk of bladder cancer with pioglitazone. They improve insulin sensitivity.

Option by option

  • A. Lactic acidosis

    Lactic acidosis is associated with metformin.

  • B. Pancreatitis

    Pancreatitis is associated with incretin therapies.

  • C. Hypoglycaemia

    Hypoglycaemia is uncommon.

  • D. Fluid retention precipitating heart failure, with fracture and bladder cancer risks (correct)

    Correct. Fluid retention is the key concern.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Fluid retention precipitating heart failure, with fracture and bladder cancer risks. Thiazolidinediones activate PPAR-gamma and cause sodium and water retention, so they are contraindicated in NYHA III-IV heart failure.

Why is "Lactic acidosis" not the answer?

Lactic acidosis is associated with metformin.

Why is "Pancreatitis" not the answer?

Pancreatitis is associated with incretin therapies.

Why is "Hypoglycaemia" not the answer?

Hypoglycaemia is uncommon.

What concept does this question test?

It tests Endocrinology: pioglitazone adverse effects in General Medicine. Other adverse effects are weight gain, fractures and an increased risk of bladder cancer with pioglitazone. They improve insulin sensitivity.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrinology: pioglitazone adverse effects?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.