Pediatric Dentistry · single question
A patient with rheumatoid arthritis taking adalimumab (Humira) and methotrexate presents for dental care. Which blood test should be monitored specifically for methotrexate toxicity?
Show answer and explanation
Correct answer: C. CBC (complete blood count) and LFTs (liver function tests)
- A. INR/PT monitors warfarin anticoagulation, not methotrexate toxicity.
- B. ANA tests for autoimmune antibodies (diagnostic for RA/lupus) — not a toxicity monitoring test for methotrexate.
- C. Correct. Methotrexate is a disease-modifying antirheumatic drug (DMARD) with potential toxicity to the BONE MARROW (causing myelosuppression — low WBC, RBC, platelets) and LIVER (hepatotoxicity). CBC (to detect blood dyscrasias) and LFTs/liver enzymes must be monitored regularly.
- D. Creatinine monitors renal function (also monitored for methotrexate since it is renally excreted), but CBC and LFTs are the primary monitoring tests.
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