Rosh Psychiatry Board Practice Exam

For a 28-year-old man with a history of schizophrenia managed with olanzapine, which screening test is most appropriate?

1. Complete blood count with differential

2. Serum lipid panel

3. Electrocardiogram

4. Fundoscopic exam

The correct answer is: Serum lipid panel

The most appropriate screening test in this scenario is the serum lipid panel. Individuals taking atypical antipsychotics such as olanzapine are at an increased risk for metabolic side effects, including dyslipidemia, weight gain, and insulin resistance. A serum lipid panel allows for monitoring cholesterol and triglyceride levels, which are important indicators of cardiovascular health. Given that the patient is managing his schizophrenia with olanzapine, monitoring for these metabolic changes becomes crucial to prevent long-term complications such as cardiovascular disease. Regular assessment of lipid levels can help in timely interventions, such as dietary modifications or pharmacological treatment, to address any abnormalities detected. Other tests, while important in different contexts, are not as directly relevant for monitoring the side effects associated with olanzapine use. A complete blood count with differential is typically used for identifying hematological side effects, an electrocardiogram may be indicated for specific cardiac concerns but does not directly monitor metabolic side effects, and a fundoscopic exam is more relevant for evaluating potential adverse effects on ocular health rather than metabolic risk.