Question

_______ is NOT a serious side effect of long-term corticosteroid therapy.

• A. Cushing's syndrome
• B. Dyslipidaemia
• C. Immune-stimulation
• D. Osteoporosis

Hint:

Corticosteroid adverse effects can be remembered with the mnemonic CUSHING: C - Cataracts U - Ulcers S - Striae Skin thinning H - Hypertension Hirsutism I - Immunosuppression (Not Stimulation!) N - Necrosis of femoral head G - Glucose elevation Growth retardation

Answer 1

The Correct Option is C

Concept: Glucocorticoids (corticosteroids) are powerful anti-inflammatory and immunosuppressive agents. They act by binding to intracellular glucocorticoid receptors, which downregulates the transcription of pro-inflammatory cytokines (like IL-1, IL-2, IL-6, and TNF-$\alpha$) and suppresses cell-mediated immunity.

Step 1: Evaluate the impact of long-term therapy on the immune system.
Because corticosteroids suppress the activation of T-lymphocytes and decrease cytokine production, long-term therapy leads to immunosuppression (increased susceptibility to infections), not immune-stimulation. Therefore, "Immune-stimulation" is NOT a side effect of corticosteroid therapy.

Step 2: Confirm known corticosteroid complications.
* Cushing's syndrome: Chronic exogenous corticosteroid use mimics excess cortisol production, causing a round "moon face," central obesity, and a buffalo hump. * Dyslipidaemia: Glucocorticoids alter lipid metabolism, increasing circulating free fatty acids and triglycerides. * Osteoporosis: Corticosteroids inhibit osteoblast differentiation and reduce intestinal calcium absorption, leading to bone loss.