This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: NSAIDs, Gout and Rheumatoid Ahritis, Subject name: Pharmacology
Long term use of aspirin in rheumatoid ahritis is limited by its propensity to cause: 
Select and explain. 
A. Metabolic acidosis, B. Hypersensitivity reactions, C. Gastric mucosal damage, D. Salicylism
C: Gastric mucosal damage
Answer: C: Gastric mucosal damage 
Explanation: All non-selective COX inhibitors including aspirin on long-term used can cause gastric toxicity ranging from gastritis to peptic ulcer. Selective COX-2 inhibitors have lesser propensity to cause this adverse effect. Salicylism and metabolic acidosis are seen in overdose, not with long term use.