This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Anti Microbial, Subject name: Pharmacology
Most serious side effects of amphotericin B: 
Select and explain. 
A. Hepatic damage, B. Renal damage, C. Cardiotoxicity, D. Hypochromic anemia
B: Renal damage
Answer: B: Renal damage 
Explanation: Ref: Sharma & Sharma 3rd ed. P 783Adverse Drug reactions of Amphotericin B* The most common, most serious and long term side effect of amphotericin B is Nephrotoxicity (renal tubular necrosis)* This nephrotoxicity presents with hypokalemia, hypomagnesemia secondary to renal tubular acidosis, azotemia and even irreversible damage if the dose exceeds 5g.# In order to prevent the nephrotoxicity, prior hydration with 1L of normal saline is recommended.# Liposomal preparation has lesser risk of nephrotoxicity* Hypochromic normocytic anemia is common and thrombocytopenia and leukopenia although less common but has been noted.* Intrathecal administration: Arachnoiditis and seizure* Hepatic impairment and Jaundice* Infusion related toxicity (chills, tachypnea, fever, vomiting, hypotension, anaphylaxis)