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Antipsychotic metabolic monitoring — USMLE Step 3 MCQ

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ModeratePsychiatry (outpatient management)Antipsychotic metabolic monitoringUSMLE Step 3

A 28-year-old man with schizophrenia is starting olanzapine. BMI is 31 kg/m2 and family history includes diabetes. He asks what monitoring is needed. Which of the following would you recommend at the follow-up visit?

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Correct answer: B — Check weight, blood pressure, fasting glucose or A1c, and lipids at baseline and follow-up

Second-generation antipsychotics can cause weight gain, dyslipidemia, and diabetes; baseline and follow-up metabolic monitoring is required.

Reference: APA Schizophrenia Guideline; ADA/APA Antipsychotic Metabolic Monitoring Consensus