Soru

A 41-year-old woman is evaluated in the rheumatology clinic for a follow-up visit. Two weeks ago, she was diagnosed with highly active, seropositive rheumatoid arthritis after presenting with persistent symmetric polyarthritis of her wrists, metacarpophalangeal, and proximal interphalangeal joints. She has no other medical conditions and takes no medications other than ibuprofen as needed. Physical examination shows active synovitis in both hands. Recent laboratory studies from her initial diagnostic workup demonstrate a normal complete blood count, normal comprehensive metabolic panel, positive rheumatoid factor, and positive anti-cyclic citrullinated peptide antibodies. After a discussion of treatment goals, the physician and patient agree to initiate systemic therapy with once-weekly oral methotrexate and daily folic acid supplementation. Which of the following additional tests must be obtained to establish safety baselines and rule out absolute contraindications prior to initiating this specific pharmacotherapy? (Select 2)