]> 2026-07-31T07:53:15+00:00 WBR0921 0 en Antistreptolysin titer Anti-ds DNA Rheumatoid factor Anti cyclic citrullinated peptides '''Incorrect'''-Anti cyclic citrullinated peptides are specific for rheumatoid arthritis, which is characterized by symmetrical involvement of proximal interphalangeal joints, metacarpophalangeal joints, wrists, elbows and knees with swelling, warmth, tenderness and morning stiffness lasting for more than 30 minutes. Anti-B 19 IgM antibodies '''Correct'''-Arthritis is the most common clinical manifestation of parvo B 19 virus in adults. The arthritis is usually non erosive (but erosive arthritis have been reported) and involves the proximal interphalangeal joints, metacarpophalangeal joints, the knees, the wrists, and the ankles with a stiffness lasting for less then 30 minutes after prolonged rest. Diagnostically, anti-B 19 IgM and IgG are specific for immunocompetent patients while nucleic acid amplification testing (NAAT) for detecting B 19 DNA is specific for immunosuppressed patients. Primary Care Office Vendhan Ramanujam A 45 year old female presents to her primary care physician with complaints of fatigue and pain in her proximal interphalangeal joints, metacarpophalangeal joints, wrists, elbows and knees for the past 10 days. The pain in her joints is accompanied by stiffness lasting for less than 30 minutes after prolonged rest. She also has complaints of pruritus and rashes over her arms and legs for the past 2 days. She denies any history of fever. She is a daycare worker and has been in good health previously. She further denies any history of smoking, alcohol or recent travel. She is sexually active only with her husband. Her vital signs are heart rate 82 beats/min, respiratory rate 16/minute, blood pressure 120/80 mm Hg and oral temperature 37.2 C. On physical examination, erythematous and reticular rashes are noted in her arms and legs. A swelling is elicited at the area of ulnar styloid process of the right wrist. Other joints appear to be normal. An MRI of the right wrist revealed an osseous density at the ulnar styloid process, minimal degenerative changes of the radiocarpal joint, and positive ulnar variance. A series of lab tests are ordered. Which of the following will be most likely elevated, pointing towards the diagnosis? E Infectious Disease Musculoskeletal/Rheumatology 2020-10-28T02:05:02Z 2459150.5868287 WBR0921