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DMARD monitoring abnormal results — GPhC CRA MCQ

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HardMusculoskeletal TherapeuticsDMARD monitoring abnormal resultsGPhC CRA

A 48-year-old man taking azathioprine for inflammatory bowel disease asks for advice about joint pain. His latest blood tests show WCC 2.8 x 10^9/L, neutrophils 1.1 x 10^9/L, and ALT twice the upper limit of normal. What monitoring is required?

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Correct answer: A — Urgent specialist or prescriber review because blood counts and LFTs are abnormal

Azathioprine can cause bone marrow suppression and hepatotoxicity. Low white cells and neutrophils with raised ALT require urgent review against the shared-care monitoring plan, and treatment may need to be withheld. OTC NSAID advice should not distract from abnormal safety monitoring.

Reference: BNF; SPS; NICE CKS