Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What condition is a contraindication for pioglitazone?

Obesity
Heart disease
Kidney disease
Hyperlipidemia

The correct answer is: Heart disease

Pioglitazone, a thiazolidinedione used for the management of type 2 diabetes, has specific contraindications primarily due to its effects on the cardiovascular system. The concern with pioglitazone in patients with heart disease stems from its potential to cause fluid retention, which can exacerbate conditions such as heart failure. Several clinical studies have indicated an association between thiazolidinediones and an increased risk of heart failure, particularly in patients who already have underlying heart conditions. This cardiovascular risk highlights why heart disease is a contraindication for the use of pioglitazone. In contrast, obesity, kidney disease, and hyperlipidemia do not automatically contraindicate the use of pioglitazone. While pioglitazone may have certain considerations in these conditions, such as monitoring and special precautions, it is primarily the risk of exacerbating heart failure that makes heart disease a significant concern.