Table 1. Drugs and Classes Associated With DILI and Type of Liver Injury

Question 1

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

Answer 1

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

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

Answer 2

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

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

Answer 3

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

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

Answer 4

B) Isoniazid

Rationale: Isoniazid can cause an Acute Hepatocellular (HC) injury that resembles Acute Viral Hepatitis.

Question 5

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

Answer 5

B) Methotrexate, oral

Rationale: Oral Methotrexate is linked to liver injuries leading to Fatty liver and fibrosis.

Question 6

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

Answer 6

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

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

Answer 7

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

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

Answer 8

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

Question 9: Which drug may result in a liver injury resembling Autoimmune Hepatitis (AIH)?

A) Interferon-alfa
B) Lamotrigine
C) Fluoroquinolones
D) Minocycline

Answer 9

A) Interferon-alfa

Rationale: Interferon-alfa can cause a liver injury that is AIH-like.

Abbreviation Explained: AIH = Autoimmune Hepatitis

Question 10

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

Answer 10

C) Sulfasalazine

Rationale: Sulfasalazine’s Cholestatic (C) liver injury may sometimes be associated with immunoallergic features.

Question 11

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

Answer 11

A) Valproate

Rationale: Valproate can cause liver injuries resulting in symptoms of Hyperammonemia, Hepatocellular (HC) injury, and a Reye-like syndrome.

Question 12

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

Answer 12

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

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

Answer 13

A) Flavocoxid

Rationale: Flavocoxid is associated with liver injuries that can manifest as mixed, Hepatocellular (HC), or Cholestatic (C).

Question 14

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

Answer 14

B) Carbamazepine

Rationale: Carbamazepine, used in treating seizures, can lead to a Hepatocellular (HC) liver injury and may sometimes have immunoallergic features.

Question 15

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

Answer 15

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

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

Answer 16

A) Minocycline

Rationale: Minocycline can cause liver injury that may resemble Autoimmune Hepatitis (AIH).

Abbreviation Explained: AIH = Autoimmune Hepatitis

Question 17

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

Answer 17

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

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

Answer 18

C) Methotrexate, oral

Rationale: Methotrexate, when taken orally, can lead to liver injuries manifesting as Fatty liver and fibrosis.

Question 19

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

Answer 19

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

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

Answer 20

C) Pyrrolizidine alkaloids

Rationale: Pyrrolizidine alkaloids can cause liver injuries that result in Sinusoidal Obstruction Syndrome or Venoocclusive Disease.

Question 21

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

Answer 21

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

Question 22: Which drug’s liver injury can resemble Acute Viral Hepatitis?

A) Isoniazid
B) Macrolides
C) Interferon-beta
D) Fluoroquinolones

Answer 22

A) Isoniazid

Rationale: Isoniazid’s liver injury can resemble Acute Viral Hepatitis.

Question 23

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

Answer 23

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

Question 24

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

Answer 24

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.

Question 25

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

Answer 25

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).

Question 26

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

Answer 26

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.