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1

A 22-year-old male with a history of difficult-to-treat bipolar disorder with psychotic features is undergoing a medication adjustment under the guidance of his psychiatrist. The patient was previously treated with lithium and is transitioning to clozapine. Which of the following tests will the patient need routinely?

AThyroid-stimulating hormone, prior to introducing the medication

BBasic metabolic panel, weekly

CHemoglobin A1c, weekly

DDexamethasone suppression test, monthly

EComplete blood count, weekly

2

A 63-year-old man with a history of hypertension and atrial fibrillation is brought into the emergency room and found to have a ventricular tachyarrhythmia. Ibutilide is discontinued and the patient is switched to another drug that also prolongs the QT interval but is associated with a decreased risk of torsades de pointes. Which drug was most likely administered in this patient?

AEsmolol

BDigoxin

CSotalol

DAmiodarone

EQuinidine

3

A 28-year-old man is brought to the physician by his wife because she is worried about his unusual behavior. Two weeks ago, he was promoted and is now convinced that he will soon take over the firm. He has been working overtime at the office and spends most of his nights at parties. Whenever he comes home, he asks his wife to have sex with him and rarely sleeps more than 3 hours. He has a history of a similar episode and several periods of depression over the past 2 years. He currently takes no medications. He appears impatient, repeatedly jumps up from his seat, and says, "I have more important things to do." There is no evidence of suicidal ideation. Urine toxicology screening is negative. Long-term treatment with lithium is started. Which of the following endocrine parameters should be regularly monitored in this patient while he is undergoing treatment?

AComplete blood count with differential

BSerum creatinine

CSerum aminotransferases

DSerum thyroid-stimulating hormone

ESerum lithium levels

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