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Methotrexate monitoring — GPhC CRA MCQ

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ModerateMusculoskeletal TherapeuticsMethotrexate monitoringGPhC CRA

A patient starting methotrexate for rheumatoid arthritis asks why frequent blood tests are needed early in treatment. What monitoring is required?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Full blood count, liver function and renal function tests

Methotrexate can cause bone marrow, hepatic and renal toxicity. Regular FBC, LFT and renal monitoring is needed, especially during initiation and dose changes. In this scenario, the correct option is full blood count, liver function and renal function tests. The other options are plausible but do not address the key clinical, legal or safety issue as directly. This aligns with UK pharmacy practice guidance cited in the reference field.

Reference: BNF; NICE CKS