QuestionSBA
QuestionChoice
The most likely diagnosis is rheumatoid arthritis. This is a chronic inflammatory autoimmune disease, typically presenting as a symmetrical, polyarticular inflammatory arthritis involving the small joints of the hands. Risk factors for this patient include female sex and a history of smoking. The most common autoantibody present in the blood of patients with rheumatoid arthritis is anti-rheumatoid factor.
10008175
a
Anti-rheumatoid factor antibodies
QuestionChoice
Anti-thyroid peroxidase antibody is most commonly found in Hashimoto’s disease. This is an autoimmune condition affecting the thyroid gland, with patients typically presenting with symptoms of hypothyroidism. These symptoms are not present in this patient, making this option incorrect.
10008176
b
Anti-thyroid peroxidase antibody
QuestionChoice
Anti-thyroid stimulating hormone receptor antibody  is most commonly found in Grave’s disease. This is an autoimmune condition affecting the thyroid gland, with patients typically presenting with symptoms of hyperthyroidism. These symptoms are not present in this patient, making this option incorrect.
10008177
c
Anti-thyroid stimulating hormone receptor antibody
QuestionChoice
Anti-double stranded DNA antibodies are a specific maker of systemic lupus erythematosus (SLE). Although SLE can present with join problems, there is also typically evidence of systemic upset (e.g. fever, fatigue or myalgia). SLE is also much less common than rheumatoid arthritis, making this option incorrect.
10008178
d
Anti-double stranded DNA antibodies
QuestionChoice
This answer is incorrect as these antibodies are most commonly found in coeliac disease. Coeliac disease is characterised by gastrointestinal symptoms such as abdominal pain, nausea, and diarrhoea, none of which are present in this patient.
10008179
e
Anti-tissue transglutaminase IgA antibodies
Concept
Chapter
2693
4650
Autoimmune disease
Topic
158
Immunology
14182
A 41-year-old women attends the GP surgery with pain in the small joints of her hands. This has been ongoing for the past 4 months. She is also experiencing prolonged stiffness when waking up, however she mentions that using her hands at work seems to alleviate the pain.

She is usually fit and well, with no other medical conditions. However, she does smoke up to 20 cigarettes per day.

Given the most likely diagnosis, which of the following auto-antibodies will be raised?
a