Review Question - QID 213357

A 35-year-old woman presents to the clinic complaining of muscle and joint pain for the past year. She reports significant stiffness and pain in her finger joints that is worse in the morning. It is starting to interfere with her job as a receptionist and she has begun noticing deformities of her fingers (shown in Figure A.) She also reports pain and color changes in her fingertips during winter as they turn white and blue whenever she goes out in the cold. She endorses general fatigue, diffuse myalgia, weakness, swollen hands, and dyspnea. A physical examination demonstrates a patient with shiny and smooth skin and 2 oral ulcers. What antibody is the most specific for this patient’s disease?