Table 1. Drugs and Classes Associated With DILI and Type of Liver Injury Flashcards
Question 1: Which of the following drugs is most commonly associated with Hepatocellular (HC) injury or mixed liver injury, often displaying immunoallergic features?
A) Amoxicillin-clavulanate
B) Fluoroquinolones
C) Allopurinol
D) Anabolic steroids
C) Allopurinol
Rationale: Allopurinol is associated with Hepatocellular (HC) or mixed liver injuries, and it often shows immunoallergic features. This differentiates it from other drugs in the options.
Abbreviation Explained: HC = Hepatocellular
Question 2: Which drug, when contaminated, is often used in performance-enhancing products and is primarily associated with Cholestatic (C) liver injury?
A) Isoniazid
B) Anti-TNF agents
C) Anabolic steroids
D) Green tea extract
C) Anabolic steroids
Rationale: Anabolic steroids can be contaminated in performance-enhancing products and are mainly linked to Cholestatic (C) liver injury.
Abbreviation Explained: C = Cholestatic
Question 3: Which of the following drugs may resemble Autoimmune Hepatitis (AIH) when causing Hepatocellular (HC) liver injury?
A) Anti-TNF agents
B) Fluoroquinolones
C) Macrolides
D) Minocycline
A) Anti-TNF agents
Rationale: Anti-TNF agents can cause liver injuries that may resemble autoimmune hepatitis (AIH) when presenting as hepatocellular (HC) liver injury.
Abbreviation Explanation:
AIH: Autoimmune Hepatitis
HC: Hepatocellular
Question 4: Which drug is associated with liver injury that may resemble Acute Viral Hepatitis, characterized as Acute Hepatocellular (HC)?
A) Nitrofurantoin
B) Isoniazid
C) Methotrexate, oral
D) Sulfasalazine
B) Isoniazid
Rationale: Isoniazid can cause an Acute Hepatocellular (HC) injury that resembles Acute Viral Hepatitis.
Question 5: Which drug is associated with a liver injury resulting in Fatty liver and fibrosis?
A) Amoxicillin-clavulanate
B) Methotrexate, oral
C) Nitrofurantoin
D) Proton pump inhibitors
B) Methotrexate, oral
Rationale: Oral Methotrexate is linked to liver injuries leading to Fatty liver and fibrosis.
Question: Which of the following drugs is associated with a Hepatocellular (HC) liver injury that is rare?
A) Amiodarone
B) Methotrexate, oral
C) Anti-TNF agents
D) Proton pump inhibitors
E) Fluoroquinolones
D) Proton pump inhibitors
Rationale: Proton pump inhibitors (PPIs) are primarily known for reducing stomach acid production, but they can, in rare cases, cause hepatocellular (HC) liver injuries. Although liver injuries caused by PPIs are not common, it’s essential to be aware of the possibility.
Abbreviation Explanation:
HC: Hepatocellular – This refers to the type of liver injury where the damage is primarily to the liver cells themselves, as opposed to bile flow or other liver functions.
Question 7: Which of the following drugs, when associated with Cholestatic (C) liver injury, may sometimes present Hepatocellular (HC) injury?
A) Amoxicillin-clavulanate
B) Valproate
C) Fluoroquinolones
D) Sulfasalazine
A) Amoxicillin-clavulanate
Rationale: Amoxicillin-clavulanate primarily causes Cholestatic (C) liver injury but can sometimes also result in Hepatocellular (HC) liver injury.
Abbreviation Explained: C = Cholestatic, HC = Hepatocellular
Question 8: Which drug, among the options, is most associated with liver injuries such as peliosis hepatitis, nodular regenerative hyperplasia, or hepatocellular carcinoma (HCC)?
A) Green tea extract
B) Androgen-containing steroids
C) Azathioprine
D) Macrolides
B) Androgen-containing steroids
Rationale: Androgen-containing steroids can cause liver injuries that present with peliosis hepatitis, nodular regenerative hyperplasia, or HCC.
Abbreviation Explained: HCC = Hepatocellular Carcinoma
Question 9: Which drug may result in a liver injury resembling Autoimmune Hepatitis (AIH)?
A) Interferon-alfa
B) Lamotrigine
C) Fluoroquinolones
D) Minocycline
A) Interferon-alfa
Rationale: Interferon-alfa can cause a liver injury that is AIH-like.
Abbreviation Explained: AIH = Autoimmune Hepatitis
Question 10: Which drug, when associated with Cholestatic (C) liver injury, may be linked with immunoallergic features?
A) TMP-SMX
B) Azathioprine
C) Sulfasalazine
D) Nitrofurantoin
C) Sulfasalazine
Rationale: Sulfasalazine’s Cholestatic (C) liver injury may sometimes be associated with immunoallergic features.
Question 11: Which drug can potentially cause liver injury manifesting as Hyperammonemia, Hepatocellular (HC), and Reye-like syndrome?
A) Valproate
B) Carbamazepine
C) Green tea extract
D) Pyrrolizidine alkaloids
A) Valproate
Rationale: Valproate can cause liver injuries resulting in symptoms of Hyperammonemia, Hepatocellular (HC) injury, and a Reye-like syndrome.
Which of the following drugs is associated with a liver injury that can be mixed, hepatocellular (HC), and may have immunoallergic features?
A) Azathioprine
B) Lamotrigine
C) Proton pump inhibitors
D) Sulfasalazine
E) Nitrofurantoin
D) Sulfasalazine
Rationale: Sulfasalazine is known to cause liver injuries that can present in a mixed manner or as hepatocellular (HC) injuries. Additionally, these injuries can sometimes have immunoallergic features, indicating a potential allergic response of the immune system towards the drug.
Abbreviation Explanation:
Mixed: A combination of hepatocellular and cholestatic patterns of liver injury.
HC: Hepatocellular, referring to liver injuries that predominantly affect liver cells or hepatocytes.
Immunoallergic: A reaction that occurs due to the immune system’s allergic response to a drug.
Question 13: Which of the following drugs is known to lead to liver injuries primarily characterized as mixed, Hepatocellular (HC), or Cholestatic (C)?
A) Flavocoxid
B) Amiodarone
C) Phenytoin
D) Green tea extract
A) Flavocoxid
Rationale: Flavocoxid is associated with liver injuries that can manifest as mixed, Hepatocellular (HC), or Cholestatic (C).
Question 14: Which drug is often associated with a Hepatocellular (HC) liver injury, sometimes displaying immunoallergic features, and is used in treating seizures?
A) Lamotrigine
B) Carbamazepine
C) Fluoroquinolones
D) Pyrrolizidine alkaloids
B) Carbamazepine
Rationale: Carbamazepine, used in treating seizures, can lead to a Hepatocellular (HC) liver injury and may sometimes have immunoallergic features.
Which of the following drugs can cause Hepatocellular (HC) liver injury and may present with immunoallergic features?
A) Lamotrigine
B) Inhaled anesthetics
C) Methotrexate, oral
D) Minocycline
B) Inhaled anesthetics
Rationale: Based on the provided table, inhaled anesthetics have been linked with hepatocellular (HC) liver injuries and may show immunoallergic features. While some of the other options also are associated with HC injuries, the immunoallergic features specifically align with inhaled anesthetics.
Abbreviation Explanation:
HC (Hepatocellular): Refers to a type of liver injury that predominantly affects the liver cells, or hepatocytes.
Question 16: Which of the following drugs is associated with a liver injury that might resemble Autoimmune Hepatitis (AIH)?
A) Minocycline
B) Amiodarone
C) Macrolides
D) Fluoroquinolones
A) Minocycline
Rationale: Minocycline can cause liver injury that may resemble Autoimmune Hepatitis (AIH).
Abbreviation Explained: AIH = Autoimmune Hepatitis
Question 17: Which drug among the options primarily leads to Hepatocellular (HC) liver injury and may sometimes display Cholestatic (C) features?
A) Macrolides
B) Green tea extract
C) Interferon-beta
D) Phenytoin
A) Macrolides
Rationale: Macrolides are associated with Hepatocellular (HC) liver injury, but sometimes they can also display Cholestatic (C) features.
Abbreviation Explained: HC = Hepatocellular, C = Cholestatic
Question 18: Which of the following drugs, when causing liver injury, can result in Fatty liver and fibrosis?
A) Azathioprine
B) Phenytoin
C) Methotrexate, oral
D) NSAIDs
C) Methotrexate, oral
Rationale: Methotrexate, when taken orally, can lead to liver injuries manifesting as Fatty liver and fibrosis.
Question: Which of the following drugs is associated with Hepatocellular (HC) liver injury that can also manifest as mixed or cholestatic (C) patterns and frequently presents with immunoallergic features (AHS)?
A) Allopurinol
B) Amiodarone
C) Phenytoin
D) Methotrexate, oral
C) Phenytoin
Rationale: Phenytoin is known to cause hepatocellular (HC) liver injury. This injury can also present in mixed or cholestatic (C) patterns. Furthermore, Phenytoin-induced liver injury frequently exhibits immunoallergic features, often referred to as AHS.
Abbreviation Explanation:
HC: Hepatocellular - A type of liver injury primarily affecting liver cells.
C: Cholestatic - A type of liver injury characterized by a decrease in bile flow.
AHS: Immunoallergic Hepatitis Syndrome - A liver injury characterized by an allergic response that affects the liver.
Question 20: Which drug is associated with liver injury manifesting as Sinusoidal Obstruction Syndrome or Venoocclusive Disease?
A) TMP-SMX
B) Proton pump inhibitors
C) Pyrrolizidine alkaloids
D) NSAIDs
C) Pyrrolizidine alkaloids
Rationale: Pyrrolizidine alkaloids can cause liver injuries that result in Sinusoidal Obstruction Syndrome or Venoocclusive Disease.
Question 21: Which drug, when causing liver injury, can result in Hyperammonemia, Hepatocellular (HC), and Reye-like syndrome?
A) Valproate
B) TMP-SMX
C) NSAIDs
D) Azathioprine
A) Valproate
Rationale: Valproate can cause liver injuries that lead to symptoms like Hyperammonemia, Hepatocellular (HC), and a Reye-like syndrome.
Abbreviation Explained: HC = Hepatocellular
Question 22: Which drug’s liver injury can resemble Acute Viral Hepatitis?
A) Isoniazid
B) Macrolides
C) Interferon-beta
D) Fluoroquinolones
A) Isoniazid
Rationale: Isoniazid’s liver injury can resemble Acute Viral Hepatitis.
Question 23: Which drug can cause liver injury that is primarily Hepatocellular (HC) with potential immunoallergic features (AHS)?
A) Azathioprine
B) Lamotrigine
C) TMP-SMX
D) NSAIDs
B) Lamotrigine
Rationale: Lamotrigine is associated with Hepatocellular (HC) liver injury and can sometimes have immunoallergic features (AHS).
Abbreviation Explained: HC = Hepatocellular, AHS = Anticonvulsant Hypersensitivity Syndrome
Which of the following drugs is associated with a liver injury that may be Hepatocellular (HC), and/or might be associated with immunoallergic features?
A) Isoniazid
B) Azathioprine
C) Carbamazepine
D) TMP-SMX
D) TMP-SMX
Rationale: TMP-SMX can cause a type of liver injury that might be Hepatocellular (HC) and/or may be associated with immunoallergic features.
Abbreviation Explanation:
HC: Hepatocellular - This refers to liver injuries that primarily affect the liver cells or hepatocytes.
TMP-SMX: Trimethoprim-sulfamethoxazole - A combination antibiotic used to treat a variety of bacterial infections.
Which of the following drugs can manifest liver injury that in its acute form appears as Hepatocellular (HC) damage, but in its chronic form can closely resemble Autoimmune Hepatitis (AIH)?
A) Lamotrigine
B) Methotrexate, oral
C) Minocycline
D) Nitrofurantoin
D) Nitrofurantoin
Rationale: Nitrofurantoin can cause liver injuries that, in their acute presentation, resemble Hepatocellular (HC) damage. When the injury is of a chronic nature, it might closely mimic the characteristics of Autoimmune Hepatitis (AIH).
Which drug can cause a liver injury that can either be Hepatocellular (HC) or present with portal hypertension?
A) Isoniazid
B) Anti-TNF agents
C) Fluoroquinolones
D) Azathioprine
E) Minocycline
D) Azathioprine
Rationale: Azathioprine can cause a type of liver injury that is either hepatocellular (HC) or can present with portal hypertension. This differentiates it from other drugs listed, which have different patterns of liver injury.
