Question

Which of the following is a side effect of long-term corticosteroid use?

• A. Osteoporosis
• B. Hypoglycemia
• C. Hyperkalemia
• D. Weight loss

Hint:

In chronic steroid use: think “CUSHINGOID” — Cushing’s features, Osteoporosis, Immunosuppression, Diabetes.

Answer 1

The Correct Option is A

Step 1: Understanding corticosteroids
Corticosteroids are synthetic drugs that mimic the effects of cortisol, a hormone produced by the adrenal glands. They are widely used for their potent anti-inflammatory and immunosuppressive properties in conditions like asthma, rheumatoid arthritis, lupus, and inflammatory bowel disease.

Step 2: Long-term side effects
Prolonged use of corticosteroids is associated with multiple side effects, and one of the most significant is osteoporosis. Corticosteroids decrease bone formation, increase bone resorption, and reduce calcium absorption, leading to progressive bone loss and increased fracture risk.

Step 3: Mechanism of osteoporosis in corticosteroid therapy

• Reduced osteoblast activity → decreased new bone formation.
• Increased osteoclast activity → accelerated bone breakdown.
• Decreased intestinal calcium absorption and increased renal calcium excretion.

Step 4: Why other options are incorrect

• Hypoglycemia: Corticosteroids actually increase blood sugar levels, leading to hyperglycemia, not hypoglycemia.
• Hyperkalemia: Corticosteroids can cause hypokalemia (low potassium) due to their mineralocorticoid activity.
• Weight loss: Long-term use often causes weight gain due to increased appetite and fat redistribution.

Step 5: Clinical importance
Patients on long-term corticosteroids should be monitored for bone density changes and may require calcium, vitamin D supplementation, or bisphosphonates to reduce osteoporosis risk.

Osteoporosis = Major side effect of chronic corticosteroid use