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Carbimazole agranulocytosis warning — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsCarbimazole agranulocytosis warningGPhC CRA

A 45-year-old woman taking carbimazole 20mg daily for Graves' disease phones the pharmacy with a sore throat, mouth ulcers and temperature of 38.2°C. She started treatment 5 weeks ago and has no cough or urinary symptoms. What monitoring is required?

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Correct answer: D — Urgent full blood count today

Carbimazole can cause agranulocytosis, and sore throat, mouth ulcers and fever require urgent full blood count assessment. The medicine should be withheld pending clinical advice. Thyroid function monitoring is important for dose adjustment but is not the urgent safety test here. Symptomatic treatment without a blood count could delay recognition of a serious adverse reaction.

Reference: BNF Carbimazole; NICE CKS Hyperthyroidism