Rheumatoid Arthritis in Medicine / Internal Medicine — 35yo Woman | Rheumatology | SMLE Q#10498

SMLE Question #10498

Medicine / Internal Medicine Rheumatology

Objective: OBJ-383

Last updated: February 2026
A 35-year-old woman with rheumatoid arthritis in remission for 1 year takes methotrexate 15 mg weekly with folic acid. She is asymptomatic. Liver tests were normal 4 months ago. Routine monitoring now shows markedly elevated aminotransferases and low albumin. What is the most appropriate next step in management?

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