QuestionSBA
QuestionChoice
Several antipsychotics increase the risk of developing diabetes and elevating HbA1c but this is not a priority at the moment.
10034951
e
HbA1c
QuestionChoice
Whilst useful to stage the likely pneumonia using a CURB-65 score and assess for acute kidney injury, it is not as important as excluding agranulocytosis here. In reality, these tests would be ordered together.
10034948
b
Urea and electrolytes
QuestionChoice
Clozapine can cause myocarditis with an elevated troponin but the clinical picture is in keeping with pneumonia.
10034949
c
Troponin
QuestionChoice
Antipsychotics are known to worsen cholesterol levels causing them to rise but this is not a priority at the moment.
10034950
d
LDL levels
QuestionChoice
This is correct. This scenario suggests this man is on clozapine as it is the only licensed option for treatment-resistant schizophrenia which can cause profound agranulocytosis, which can result in overwhelming sepsis and death.
10034947
a
Full blood count
Concept
Chapter
2693
6108
Schizophrenia
Topic
332
Psychiatry
19393
Clozapine can cause agranulocytosis, so regular blood tests are needed to monitor white blood cell levels and prevent serious infections and complications.
A 67-year-old man with treatment-resistant schizophrenia has been transferred from the psychiatric intensive care unit to the acute medical unit at the local hospital due to a productive cough with tachypnoea and hypotension.

Which of the following investigations is it most important to order?
a