This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiratory system, Subject name: Pharmacology
Complications of inhalational steroids use include 
Select and explain. 
A. Cushing's syndrome, B. Oral candidiasis, C. Decreased ACTH, D. Systemic complications
B: Oral candidiasis
Answer: B: Oral candidiasis 
Explanation: Adverse effects Hoarseness of voice, dysphonia, sore throat, asymptomatic or symptomatic oropharyngeal candidiasis are the most common side effects. These can be minimized by the use of a spacer, gargling after every dose (to wash off the drug deposited on oral and pharyngeal mucosa) and prevented as well as treated by topical nystatin/clotrimazole. Patients who are to be switched over from oral steroid should receive inhaled steroid in addition for 1-2 weeks before oral steroid is tapered (Peak effect of inhaled steroid is seen after 4-7 days of instituting inhaled steroids and benefit persists for a few weeks after discontinuation), Otherwise steroid with-drawal may manifest (precipitation of asthma, muscular pain, lassitude, depression, hypotension). This confirms lack of systemic activity of inhaled steroids (at doses < 600 ug/day). Systemic effects of long-term inhaled glucocoicoids are clinically relevant only at doses > 600 ug/day. The significant ones are--mood changes, osteoporosis, growth retardation in children, bruising, petechiae, hyperglycaemia and pituitary-adrenal suppression; several repos of adrenal crisis have appeared, especially in children, during stress. Ref:- kd tripathi; pg num:-230,231