This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Peptic Ulcer Disease, Subject name: Medicine
Prolonged intake of PPI does not cause 
Select and explain. 
A. Hypothyroidism, B. Pelvic fracture, C. Clostridium difficile infection, D. Increased community acquired pneumonia
A: Hypothyroidism
Answer: A: Hypothyroidism 
Explanation: Long-term acid suppression, especially with PPIs, has been associated with A higher incidence of community-acquired pneumonia Community and hospital acquired Clostridium difficile associated disease. Long-term use of PPIs was associated with the development of hip fractures in older women. PPIs may exe a negative effect on the anti-platelet effect of clopidogrel. The mechanism involves the competition of the PPI and clopidogrel with the same cytochrome p450 (CYP2C19).