Metabolic Monitoring — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

ModerateSchizophrenia & PsychosisMetabolic MonitoringMRCPsych Paper B

A 25-year-old woman with a first episode of psychosis starts olanzapine 10 mg daily. Baseline fasting blood glucose and blood lipid levels are normal. She has no symptoms of hyperglycaemia or other indication for earlier testing. According to NICE, when should glycaemic status, using fasting blood glucose or HbA1c, and blood lipid levels first be repeated routinely after starting treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — 12 weeks

The correct answer is B, 12 weeks. NICE recommends measuring fasting blood glucose or HbA1c and a blood lipid profile before starting an antipsychotic, then repeating glycaemic and lipid measurements at 12 weeks, at 1 year and annually thereafter. The normal baseline results and absence of symptoms establish that the question concerns routine rather than clinically indicated early testing. Two and 4 weeks are not scheduled timepoints for routine glucose and lipid reassessment, although weight requires more frequent early monitoring. Six months is not a specified NICE timepoint. One year is a subsequent scheduled assessment, but it is not the first measurement after initiation.

Reference: National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (CG178), recommendations 1.3.6.1 and 1.3.6.4. Published 2014; amended 2021. https://www.nice.org.uk/Guidance/CG178/chapter/recommendations