Ms. Smith is a 54 y/o woman with rheumatoid arthritis (RA) on methotrexate. She reports worsening joint pain in both hands over the past 3 weeks. There is no evidence of synovitis on exam. She has not had any fevers. Her mother's history of breast cancer is noted. Dr. Jones recommended increasing folic acid to 2 mg daily and checking CBC, LFTs, and ESR. RA activity score improved from 5.2 to 3.1. Patient's blood pressure was 128/82 mmHg.
