Psychopharmacology: lithium pre-treatment: practice question

A Psychiatry 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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Psychiatry · Psychopharmacology: lithium pre-treatment

Sample item

Which set of investigations is part of the work-up before starting lithium?

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

The answer and the reasoning

A. Renal function, thyroid function, ECG and pregnancy test

Lithium is renally cleared and affects the thyroid and heart, so baseline urea, creatinine, eGFR, TSH, ECG (in those over 40 or with cardiac disease), calcium and pregnancy status are checked. Levels are then monitored regularly.

Option by option

  • A. Renal function, thyroid function, ECG and pregnancy test (correct)

    Correct. These are the standard baseline tests.

  • B. Liver biopsy

    Liver biopsy is not needed.

  • C. CSF analysis

    CSF analysis is not part of the work-up.

  • D. Serum ceruloplasmin

    Ceruloplasmin is for Wilson disease.

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.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Renal function, thyroid function, ECG and pregnancy test. Lithium is renally cleared and affects the thyroid and heart, so baseline urea, creatinine, eGFR, TSH, ECG (in those over 40 or with cardiac disease), calcium and pregnancy status are checked.

Why is "Liver biopsy" not the answer?

Liver biopsy is not needed.

Why is "CSF analysis" not the answer?

CSF analysis is not part of the work-up.

Why is "Serum ceruloplasmin" not the answer?

Ceruloplasmin is for Wilson disease.

What concept does this question test?

It tests Psychopharmacology: lithium pre-treatment in Psychiatry. Levels are then monitored regularly.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Psychopharmacology: lithium pre-treatment?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.