25th February 2025

A 40-year-old with psoriatic arthritis describes 2 months of night sweats and a worsening cough, with some recent blood in the sputum.

A 40-year-old with psoriatic arthritis describes 2 months of night sweats and a worsening cough, with some recent blood in the sputum. He was not born in the UK.

FBC shows:

Hb 108 (120-180)

MCV 91 (90-97)

Plts 200 (150-450)

WCC 13 (4-11)

Neutrophils 9 (1.5-8)

Lymphocytes 2.1 (1.1-4)

Monocytes 1.3 (0.2-1.1)

Eosinophils 0.5 (0.1-0.4)

Basophils 0.1 (0-0.3)

There is no growth on a viral swab and rapid sputum sample.

A chest X-ray shows the following:

Which drug was he most likely recently started on?

Select the SINGLE most appropriate option from the list below. Select ONE option only.