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Chapter 47 – Rheumatoid Arthritis (QE) Sample Questions

1. When monitoring a patient on long-term Methotrexate (MTX) for Rheumatoid Arthritis, which laboratory parameter is essential to check every 1 to 2 months according to the therapeutic guidelines?

A. Ophthalmic baseline and annual exams.
B. Bone mineral density (BMD).
C. Serum B12 and Folate levels.
D. Hepatic enzymes and renal function.

Answer

Ans: D

Tips: MTX is known for potential hepatotoxicity and is renally excreted, necessitating regular monitoring of LFTs and creatinine.
Ophthalmic monitoring is specific to Hydroxychloroquine, not Methotrexate.
Bone mineral density (BMD).BMD monitoring is typically used for patients on long-term corticosteroids or those with osteoporosis risk, not specifically for MTX.
Serum B12 and Folate levels. While folic acid is supplemented to reduce side effects, the primary monitoring focus is on organ toxicity rather than vitamin levels.

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