QuestionSBA
QuestionChoice
Prior to starting lithium renal, cardiac and thyroid function should be monitored. Renal function is monitored due to the risk of toxicity if there is improper clearance of lithium. Cardiac function is monitored due to the risk of cardiac disease such as QT interval prolongation.
Body weight should also be measured prior to starting treatment and a full blood count should be taken.
50404
a
ECG, renal function, thyroid function tests
QuestionChoice
Prior to starting lithium renal, cardiac and thyroid function should be monitored. Body weight should also be measured prior to starting treatment and a full blood count should be taken. Whilst there have been reported LFT abnormalities in patients taking lithium, these are rare and do not require monitoring. A CT head is not a required part of monitoring either.
50408
e
ECG, liver function, CT head
QuestionChoice
Prior to starting lithium renal, cardiac and thyroid function should be monitored. Body weight should also be measured prior to starting treatment and a full blood count should be taken. Whilst there have been reported LFT abnormalities in patients taking lithium, these are rare and do not require monitoring.
50406
c
ECG, liver function, renal function
QuestionChoice
Prior to starting lithium renal, cardiac and thyroid function should be monitored. Body weight should also be measured prior to starting treatment and a full blood count should be taken. A chest x-ray is not routinely be used for monitoring prior to starting lithium.
50407
d
Chest X-ray, thyroid function test, renal function
QuestionChoice
Prior to starting lithium renal, cardiac and thyroid function should be monitored. Body weight should also be measured prior to starting treatment and a full blood count should be taken. A chest x-ray wouldn't routinely be used for monitoring prior to starting lithium.
50405
b
Chest X-ray, ECG, renal function
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
3664
Monitoring is required prior to starting lithium
Topic
90
Psychiatry
10135
Case presentation: A 28 year old woman is seen in the outpatient psychiatry clinic and is diagnosed with bipolar disorder. She is advised to commence treatment with lithium carbonate (Camcolit) 400mg PO OD.


Question: Select the most appropriate monitoring that this patient should undergo prior to starting lithium carbonate.
a