Baseline Antipsychotic Monitoring — MRCPsych Paper B MCQ
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Correct answer: B — Weight, waist circumference, pulse and blood pressure, fasting blood glucose or HbA1c, lipid profile and prolactin, movement-disorder assessment, and assessment of nutritional status, diet and physical activity
Explanation lettering: C = shown as A · E = shown as C · A = shown as E
B is correct. NICE CG178 specifies baseline weight, waist circumference, pulse and blood pressure, fasting blood glucose or HbA1c, lipid profile and prolactin levels. Clinicians should also assess pre-existing movement disorders and nutritional status, diet and physical activity. Fasting glucose and HbA1c are alternatives; both are not routinely required. An ECG is not mandatory for every patient: it is offered when required by the medicine's product information, when cardiovascular risk or a personal cardiovascular history is present, or on inpatient admission. Full blood count, renal, liver and thyroid tests may be clinically indicated, but they are not all components of the universal CG178 baseline set. Echocardiography and chest radiography are not routine baseline requirements.
Reference: National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (CG178), recommendations 1.3.6.1–1.3.6.2. 2014, amended 2021. https://www.nice.org.uk/guidance/cg178/chapter/recommendations