Psychopharmacology: lithium and leucocytosis: 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 and leucocytosis

Sample item

A 35-year-old man on lithium for six months has a white cell count of 12,500 per microlitre with normal differential and no fever or infection. What is the correct interpretation?

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

The answer and the reasoning

D. Benign leucocytosis caused by lithium, needing no action

Lithium stimulates granulopoiesis and commonly causes a benign rise in neutrophil count, which is reversible on stopping the drug. It differs from clozapine, which causes neutropenia.

Option by option

  • A. Evidence of occult infection that needs antibiotics

    No features of infection are present.

  • B. Lithium toxicity requiring immediate dialysis

    Raised white count does not indicate lithium toxicity, which is a neurological and gastrointestinal picture.

  • C. Early agranulocytosis

    Agranulocytosis is a fall, not a rise, in white cells.

  • D. Benign leucocytosis caused by lithium, needing no action (correct)

    Correct. A mild neutrophilia without infection is a benign effect of lithium.

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 D, Benign leucocytosis caused by lithium, needing no action. Lithium stimulates granulopoiesis and commonly causes a benign rise in neutrophil count, which is reversible on stopping the drug.

Why is "Evidence of occult infection that needs antibiotics" not the answer?

No features of infection are present.

Why is "Lithium toxicity requiring immediate dialysis" not the answer?

Raised white count does not indicate lithium toxicity, which is a neurological and gastrointestinal picture.

Why is "Early agranulocytosis" not the answer?

Agranulocytosis is a fall, not a rise, in white cells.

What concept does this question test?

It tests Psychopharmacology: lithium and leucocytosis in Psychiatry. It differs from clozapine, which causes neutropenia.

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 and leucocytosis?

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.