A 47-Year-Old Woman Comes to the Physician with Progressive Joint

question 329

Multiple Choice

A 47-year-old woman comes to the physician with progressive joint pain and swelling in her hands for the past several months.  She also has easy fatigability that has gradually worsened over the same period.  Morning activities are especially difficult due to stiffness lasting 1 to 2 hours after waking.  Examination shows warmth, swelling, and tenderness involving the proximal interphalangeal joints, metacarpophalangeal joints, and wrists bilaterally.  A blood sample is obtained for laboratory analysis.  Autoantibodies against which of the following components are most specific for this patient's condition?

• A)Centromeres
• B)Citrullinated peptides
• C)Double-stranded DNA
• D)Fc portion of human IgG
• E)Nuclear basic proteins
• F)Phospholipids