Professional and Linguistic Assessments Board (PLAB) Practice Exam

Which condition is likely to cause drug-induced hepatitis?

1. Alcohol abuse

2. Over-the-counter pain relievers

3. Viral infections

4. Nonsteroidal anti-inflammatory drugs (NSAIDs)

The correct answer is: Over-the-counter pain relievers

Drug-induced hepatitis can occur due to several factors, and among the listed options, over-the-counter pain relievers, particularly acetaminophen (paracetamol), are known to be significant contributors. Acetaminophen is widely used for pain relief and fever reduction, but in excessive doses or in individuals with certain predisposing factors, it can lead to liver damage. This liver injury is often termed drug-induced hepatitis. The mechanism typically involves the metabolism of acetaminophen, which can produce a toxic metabolite when overdosed, overwhelming the liver's capacity to safely process the drug. When this happens, it can lead to hepatocyte damage and subsequently a pattern of injury consistent with hepatitis. In contrast, while alcohol abuse can lead to liver disease, and NSAIDs can cause liver issues in rare cases, they are not as commonly linked to drug-induced hepatitis as acetaminophen. Viral infections are a completely different etiology and not classified under drug-induced liver problems. Therefore, the option regarding over-the-counter pain relievers accurately reflects a well-established association with drug-induced hepatitis.