A patient on Clozapine develops fever. What is the most important test to perform?

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Multiple Choice

A patient on Clozapine develops fever. What is the most important test to perform?

Explanation:
Clozapine carries a significant risk of agranulocytosis, and fever can be the first sign of a dangerous drop in neutrophils. The most important test is a CBC with differential to determine the absolute neutrophil count. Detecting neutropenia quickly guides urgent actions—holding clozapine and initiating appropriate management—because agranulocytosis can progress rapidly and lead to severe infection. While a chest X-ray might be helpful if an infection is suspected, it does not assess the immediate risk posed by neutropenia, and thyroid function or lipid panels don’t address the fever in this context.

Clozapine carries a significant risk of agranulocytosis, and fever can be the first sign of a dangerous drop in neutrophils. The most important test is a CBC with differential to determine the absolute neutrophil count. Detecting neutropenia quickly guides urgent actions—holding clozapine and initiating appropriate management—because agranulocytosis can progress rapidly and lead to severe infection. While a chest X-ray might be helpful if an infection is suspected, it does not assess the immediate risk posed by neutropenia, and thyroid function or lipid panels don’t address the fever in this context.

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