WBR0477
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Behavioral Science/Psychiatry, MainCategory::Pharmacology |
| Sub Category | SubCategory::Hematology |
| Prompt | [[Prompt::A 19 year old male patient is admitted to the hospital for auditory hallucinations and delusions for more than 1 year. The patient has been previously diagnosed with schizophrenia and has been refractory to antipsychotic treatment. The physician decides to start the patient on clozapine despite its associated risk. Which of the following lab tests must be routinely performed in this patient to monitor for clozapine adverse reaction?]] |
| Answer A | AnswerA::Liver transaminases |
| Answer A Explanation | AnswerAExp::Liver transaminase testing is not routinely performed with clozapine treatment. |
| Answer B | AnswerB::Creatinine |
| Answer B Explanation | AnswerBExp::Creatinine testing is not routinely performed with clozapine treatment. |
| Answer C | AnswerC::Complete blood count (CBC) |
| Answer C Explanation | AnswerCExp::Due to risk of agranulocytosis, a CBC must be routinely performed in patients on clozapine. |
| Answer D | AnswerD::Electrolyte panel |
| Answer D Explanation | AnswerDExp::Electrolyte panel testing is not routinely performed with clozapine treatment. |
| Answer E | AnswerE::Fasting blood glucose |
| Answer E Explanation | AnswerEExp::Fasting blood glucose testing is not routinely performed with clozapine treatment. |
| Right Answer | RightAnswer::C |
| Explanation | [[Explanation::Clozapine is a second generation antipsychotic medication that has been proven to be highly effective in the treatment of negative symptoms, in addition to the positive symptoms of schizophrenia. Nonetheless, clozapine is reserved for refractory cases of schizophrenia despite its efficacy due to its association with agranulocytosis in approximately 1% of patients. As a result, periodic complete blood count (CBC) must be performed in patients with clozapine to monitor for any signs of agranulocytosis.
Educational Objective:
Clozapine is an effective second generation antipsychotic medication to treat positive and negative symptoms. Its use is reserved for refractory cases due to its association with agranulocytosis in approximately 1% of the cases. |
| Approved | Approved::No |
| Keyword | WBRKeyword::schizophrenia, WBRKeyword::clozapine, WBRKeyword::second, WBRKeyword::generation, WBRKeyword::antipsychotic, WBRKeyword::antipsychotics, WBRKeyword::second generation antipsychotics, WBRKeyword::agranulocytosis, WBRKeyword::adverse, WBRKeyword::drug, WBRKeyword::reaction, WBRKeyword::side, WBRKeyword::effect, WBRKeyword::complete, WBRKeyword::blood, WBRKeyword::count, WBRKeyword::cbc, WBRKeyword::complete blood count |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |