Antipsychotics: clozapine: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antipsychotics: clozapine

Sample item

A 29-year-old woman with treatment-resistant schizophrenia, on clozapine for 6 weeks, develops fever and a sore throat. What is the most appropriate next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Urgent absolute neutrophil count and hold clozapine pending the result

Clozapine can cause agranulocytosis, with the highest risk in the first 18 weeks, which is why a neutrophil count is mandatory at regular intervals. Fever or sore throat requires an urgent count, and the drug is withheld if neutropenia is confirmed. Her other risks include myocarditis, seizures, sialorrhoea and metabolic effects.

Option by option

  • A. Reassure that these are expected early adverse effects

    Fever and sore throat are warning signs of agranulocytosis, not harmless early effects.

  • B. Increase the clozapine dose to control agitation

    Increasing the dose would worsen any marrow toxicity.

  • C. Oral amoxicillin and review in a week

    Empirical oral antibiotics with delayed review risks missed neutropenic sepsis.

  • D. Urgent absolute neutrophil count and hold clozapine pending the result (correct)

    Fever with sore throat on clozapine suggests agranulocytosis and needs an immediate count.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Urgent absolute neutrophil count and hold clozapine pending the result. Clozapine can cause agranulocytosis, with the highest risk in the first 18 weeks, which is why a neutrophil count is mandatory at regular intervals.

Why is "Reassure that these are expected early adverse effects" not the answer?

Fever and sore throat are warning signs of agranulocytosis, not harmless early effects.

Why is "Increase the clozapine dose to control agitation" not the answer?

Increasing the dose would worsen any marrow toxicity.

Why is "Oral amoxicillin and review in a week" not the answer?

Empirical oral antibiotics with delayed review risks missed neutropenic sepsis.

What concept does this question test?

It tests Antipsychotics: clozapine in Pharmacology. Fever or sore throat requires an urgent count, and the drug is withheld if neutropenia is confirmed. Her other risks include myocarditis, seizures, sialorrhoea and metabolic effects.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antipsychotics: clozapine?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.