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Briefing — read this before starting. The transcript will appear here once the consultation begins.
Doctor Notes
Patient Information
Name: Margaret Ellison
Age: 62 years
Gender: Female
Reason for Appointment
Recall appointment: routine methotrexate monitoring bloods flagged — ALT significantly raised. Margaret Ellison, 62, rheumatoid arthritis, shared care with rheumatology.
Medical History
Past Medical History
Rheumatoid arthritis (seropositive, 12 years). Hypertension.
Drug History
Methotrexate 15 mg weekly (Sundays); folic acid 5 mg weekly; amlodipine 5 mg OD.
Monitoring bloods (this week)
This week: ALT 118 (baseline 20–35 for five years); ALP, bilirubin and albumin normal. FBC normal (neutrophils 4.2). eGFR 74, stable. All previous LFTs normal.
Shared care record
Shared-care agreement with rheumatology in place; advice line available. Last rheumatology review 5 months ago: "excellent control — continue".