MCQ Medicine Answer 19

The Correct Answer is E

Explanation:

All of the answers are correct.

Methotrexate is currently the best drug used to treat rheumatoid arthritis, with initial improvement seen in 3 to 6 weeks and peak efficacy in 4 to 6 months. Adverse effects such as nausea, abdominal pain, and diarrhea are frequently seen, but serious toxicity is rare.

Methotrexate is taken orally (7.5-15 mg/week), and tolerance may be increased by spacing the oral doses over 1 to 2 days, giving a single intramuscular injection each week and daily folic acid (1 mg/day) supplementation. Laboratory tests such as CBC, platelet count, alkaline phosphatase, and SGOT are done every 4 to 6 weeks.

The most toxic drug-related side effects are pancytopenia, neutropenia, thrombocytopenia, pneumonitis, and cirrhosis; all are reasons to stop the medications. Transient or sustained (1.5-2 times normal values) elevations in alkaline phosphatase and SGOT are commonly seen and, in the majority of patients, generally do not portend the development of hepatic fibrosis.


Methotrexate is known to be teratogenic and should not be given to women with childbearing potential unless they are using an adequate method of birth control. Because of its potential effect on sperm, men should discontinue methotrexate 3 to 4 months before attempting conception.

Category: Internal Medicine MCQs , Medicine MCQs