This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Kidney, Subject name: Pharmacology
Long-term use of which diuretic agent can result in gynaecomastia 
Select and explain. 
A. Amiloride, B. Spironolactone, C. Triamterene, D. Acetazolamide
B: Spironolactone
Answer: B: Spironolactone 
Explanation: POTASSIUM SPARING DIURETICS Aldosterone antagonist Spironolactone:- It is a steroid, chemically related to the mineralocoicoid aldosterone. Aldosterone penetrates the late DT and CD cells and acts by combining with an intracellular mineralocoicoid receptor (MR) -> induces the formation of 'aldosterone-induced proteins' (AIPs). The AIPs promote Na+ reabsorption by a number of mechanisms and K+ secretion. Spironolactone acts from the interstitial side of the tubular cell, combines with MR and inhibits the formation of AIPs in a competitive manner. Adverse effects:- The side effects are drowsiness, ataxia, mental confusion, epigastric distress and loose motions. Spironolactone interacts with progestin and androgen receptors as well. In addition, it may enhance testosterone clearance or its peripheral conversion to estradiol, producing dose and duration of treatment related hormonal side effects like gynaecomastia, erectile dysfunction or loss of libido in men, and breast tenderness or menstrual irregularities in women. Most serious is hyperkalaemia that may occur, especially if renal function is inadequate. Acidosis is a risk, paicularly in cirrhotics. Peptic ulcer may be aggravated; it is contraindicated in ulcer patients. Ref:- kd tripathi; pg num:-587,589