QuestionSBA
QuestionChoice
Clozapine monitoring includes: ECG, prolactin, full blood count, lipid profile and fasting blood glucose. A full blood count is part of routine monitoring due to the high risk of agranulocytosis when taking clozapine. A lipid profile is part of routine monitoring due to the increased risk of dyslipidaemia. A fasting blood glucose part of routine monitoring due to the increased risk of developing diabetes mellitus.
50191
a
Full blood count, lipid profile, fasting blood glucose
QuestionChoice
Clozapine monitoring includes: ECG, prolactin, full blood count, lipid profile and fasting blood glucose. Hepatic function is not normally monitored in patients taking clozapine.
50193
c
Full blood count, liver function tests, lipid profile
QuestionChoice
Clozapine monitoring includes: ECG, prolactin, full blood count, lipid profile and fasting blood glucose. Hepatic function is not normally monitored in patients taking clozapine. A chest x-ray is also not a part of the routine monitoring.
50194
d
Full blood count, chest x-ray, liver function tests
QuestionChoice
Clozapine monitoring includes: ECG, prolactin, full blood count, lipid profile and fasting blood glucose. Renal function is not normally monitored in patients taking clozapine.
50192
b
Full blood count, renal function, fasting blood glucose
QuestionChoice
Clozapine monitoring includes: ECG, prolactin, full blood count, lipid profile and fasting blood glucose. Renal and hepatic function tests are not normally monitored in patients taking clozapine.
50195
e
Full blood count, renal function, liver function tests
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3616
Monitoring requirements before starting clozapine therapy
Topic
90
Psychiatry
10086
Case Presentation:  A 26-year-old known schizophrenic is seen in the outpatient psychiatric department.


**Investigations**

Cardiovascular examination: Heart sounds I + II present, no added sounds.

ECG today: normal sinus rhythm

Prolactin today: 6 ng/mL (<20 ng/mL)

He is complaining of ongoing symptoms despite being treated with risperidone. He has also previously been treated with quetiapine which had to be switched due to lack of efficacy.

It is decided that he should be switched from risperidone to clozapine.

Question: What monitoring is required if a patient is taking clozapine?
a