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Methotrexate monitoring symptoms — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsMethotrexate monitoring symptomsGPhC CRA

A patient taking weekly methotrexate reports mouth ulcers, sore throat and unusual bruising. His next monitoring blood test is due in 3 weeks. What monitoring is required?

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Correct answer: D — Advise urgent blood tests and prescriber review before the next dose

Mouth ulcers, sore throat and bruising can indicate methotrexate toxicity or bone marrow suppression. Urgent assessment and blood tests are required rather than waiting for routine monitoring. The next dose should be discussed with the prescriber. Symptomatic treatment alone would not address the safety concern.

Reference: BNF; SPS Medicines Monitoring