Q. A 65-year-old woman comes to the clinic because of difficult and painful swallowing for the past 2 months, but for the most part she can still eventually swallow if she works through the pain. She is a rheumatoid arthritis patient that has been treated with methotrexate for the past 10 years. She has smoked one pack of cigarettes a day for the past 30 years. Her BMI is 24 kg/meters squared. Temperature is 36.7 (98.7 F), Blood Pressure is 130/80, Heart Rate is 72 beats/minute. Neurological examination is unremarkable. Cardiopulmonary auscultation is normal. No masses present on abdominal examination. On examination, she has white plaques over her tongue that are scraped off easily with underlying erythema and bleeding. You strongly suspect that she is suffering from candida esophagitis. Which of the following is the appropriate next best step?