WBR0477: Difference between revisions

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(Created page with "{{WBRQuestion |QuestionAuthor={{Rim}} |ExamType=USMLE Step 1 |MainCategory=Behavioral Science/Psychiatry, Pharmacology |SubCategory=Hematology |MainCategory=Behavioral Science...")
 
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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Behavioral Science/Psychiatry, Pharmacology
|MainCategory=Behavioral Science/Psychiatry, Pharmacology
Line 20: Line 20:
|MainCategory=Behavioral Science/Psychiatry, Pharmacology
|MainCategory=Behavioral Science/Psychiatry, Pharmacology
|SubCategory=Hematology
|SubCategory=Hematology
|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?
|Prompt=A 19-year-old male is admitted to the hospital for auditory hallucinations and delusions, with a duration of over 1 year.  The patient has schizophrenia and is refractory to antipsychotic treatment. The physician decides to start the patient on clozapine despite associated risks.  Which of the following lab tests should be routinely performed to monitor for clozapine adverse reaction?
|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.  
|Explanation=[[Clozapine]], a second generation antipsychotic medication, is highly effective in the treatment of symptoms characteristic of schizophrenia.  [[Clozapine]] is reserved for refractory cases of schizophrenia, due to its association with [[agranulocytosis]] in approximately 1% of patients. Periodic complete blood count (CBC) must be performed in patients administered [[clozapine]], to monitor for any signs of [[agranulocytosis]].  
 
|EducationalObjectives= [[Clozapine]], a second generation antipsychotic medication, is highly effective in the treatment of symptoms characteristic of schizophrenia. [[Clozapine]] is reserved for refractory cases of schizophrenia, due to its association with [[agranulocytosis]] in approximately 1% of patients.
|References= First Aid 2014 page 253


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.
|AnswerA=Liver transaminases
|AnswerA=Liver transaminases
|AnswerAExp=Liver transaminase testing is not routinely performed with clozapine treatment.
|AnswerAExp=Liver transaminase testing is not routinely performed upon [[clozapine]] administration.
|AnswerB=Creatinine
|AnswerB=Creatinine
|AnswerBExp=Creatinine testing is not routinely performed with clozapine treatment.
|AnswerBExp=Creatinine testing is not routinely performed upon [[clozapine]] administration.
|AnswerC=Complete blood count (CBC)
|AnswerC=Complete blood count (CBC)
|AnswerCExp=Due to risk of agranulocytosis, a CBC must be routinely performed in patients on clozapine.
|AnswerCExp=Due to the risk of [[agranulocytosis]], a CBC must be routinely performed in patients administered [[clozapine]].
|AnswerD=Electrolyte panel
|AnswerD=Electrolyte panel
|AnswerDExp=Electrolyte panel testing is not routinely performed with clozapine treatment.
|AnswerDExp=Electrolyte panel testing is not routinely performed upon [[clozapine]] administration.
|AnswerE=Fasting blood glucose
|AnswerE=Fasting blood glucose
|AnswerEExp=Fasting blood glucose testing is not routinely performed with clozapine treatment.
|AnswerEExp=Fasting blood glucose testing is not routinely performed upon [[clozapine]] administration.
|RightAnswer=C
|RightAnswer=C
|WBRKeyword=schizophrenia, clozapine, second, generation, antipsychotic, antipsychotics, second generation antipsychotics, agranulocytosis, adverse, drug, reaction, side, effect, complete, blood, count, cbc, complete blood count
|WBRKeyword=schizophrenia, clozapine, antipsychotics, second generation antipsychotics, agranulocytosis, adverse drug reaction, side effect, CBC, complete blood count, monitoring, mental health, neurological
|Approved=No
|Approved=Yes
}}
}}

Revision as of 14:13, 29 July 2014
Author [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
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 is admitted to the hospital for auditory hallucinations and delusions, with a duration of over 1 year. The patient has schizophrenia and is refractory to antipsychotic treatment. The physician decides to start the patient on clozapine despite associated risks. Which of the following lab tests should be routinely performed to monitor for clozapine adverse reaction?]]
Answer A AnswerA::Liver transaminases
Answer A Explanation [[AnswerAExp::Liver transaminase testing is not routinely performed upon clozapine administration.]]
Answer B AnswerB::Creatinine
Answer B Explanation [[AnswerBExp::Creatinine testing is not routinely performed upon clozapine administration.]]
Answer C AnswerC::Complete blood count (CBC)
Answer C Explanation [[AnswerCExp::Due to the risk of agranulocytosis, a CBC must be routinely performed in patients administered clozapine.]]
Answer D AnswerD::Electrolyte panel
Answer D Explanation [[AnswerDExp::Electrolyte panel testing is not routinely performed upon clozapine administration.]]
Answer E AnswerE::Fasting blood glucose
Answer E Explanation [[AnswerEExp::Fasting blood glucose testing is not routinely performed upon clozapine administration.]]
Right Answer RightAnswer::C
Explanation [[Explanation::Clozapine, a second generation antipsychotic medication, is highly effective in the treatment of symptoms characteristic of schizophrenia. Clozapine is reserved for refractory cases of schizophrenia, due to its association with agranulocytosis in approximately 1% of patients. Periodic complete blood count (CBC) must be performed in patients administered clozapine, to monitor for any signs of agranulocytosis.

Educational Objective: Clozapine, a second generation antipsychotic medication, is highly effective in the treatment of symptoms characteristic of schizophrenia. Clozapine is reserved for refractory cases of schizophrenia, due to its association with agranulocytosis in approximately 1% of patients.
References: First Aid 2014 page 253]]

Approved Approved::Yes
Keyword WBRKeyword::schizophrenia, WBRKeyword::clozapine, WBRKeyword::antipsychotics, WBRKeyword::second generation antipsychotics, WBRKeyword::agranulocytosis, WBRKeyword::adverse drug reaction, WBRKeyword::side effect, WBRKeyword::CBC, WBRKeyword::complete blood count, WBRKeyword::monitoring, WBRKeyword::mental health, WBRKeyword::neurological
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