The answer is D) CBC. Clozapine is indicated for treatment refractory schizophrenia and may be an option after a patient has failed other antipsychotics. However, there is a small but important risk of agranulocytosis, which may be fatal. A regular CBC to check white blood cell levels is required in patients taking clozapine. It would be reasonable to check A) a basic metabolic panel and B) HbA1c in this patient, as clozapine, like most 2nd generation antipsychotics, will likely have metabolic side effects. These may include weight gain, insulin resistance, and increase in blood lipid levels. However, agranulocytosis is a more pressing concern as it could lead to a fatal sepsis and requires strict follow up. Clozapine is also associated with myocarditis (rarer) and more commonly with gastrointestinal hypomotility (e.g. constipation.) A C) CK level is usually checked when muscle breakdown is suspected, and is elevated in neuroleptic malignant syndrome, a rare disorder usually associated with first generation antipsychotics.
Publication reference : Kar N, Barreto S, Chandavarkar R. Clozapine Monitoring in Clinical Practice: Beyond the Mandatory Requirement. Clin Psychopharmacol Neurosci. 2016 Nov 30;14(4):323-329. doi: 10.9758/cpn.2016.14.4.323. Review. PubMed PMID: 27776383; PubMed Central PMCID: PMC5083942.
Reference URL: https://www-ncbi-nlm-nih-gov/pmc/articles/PMC5083942/
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