This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gastro-Intestinal Tract, Subject name: Pharmacology
[{'content': 'Which is not a long term adverse effect of proton pump inhibitors? \nSelect and explain. \nA. Pelvic fracture, B. Pneumonia, C. Vitamin -B12 deficiency, D. Hypothyroidism', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Proton pump inhibitors (PPI) - They are the strongest acid inhibiting drugs. - All PPI are prodrugs. - They are enteric coated - They are irreversible inhibitors of the proton pump. So, they work like hit &run drugs. - They inhibit CYP2C19. - Adverse effects o Osteoporosis (calcium deficiency) o Megaloblastic anaemia (Vitamin B12 deficiency) o Increased infection (like pneumonia) o Carcinoid tumor (seen in rats and mice) o hypergatrinemia following withdrawal of drug', 'role': 'assistant'}]