<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 53-year-old woman presents to her primary care physician with joint pain. She reports a 6-month history of progressive pain in her hands that is worse around her knuckles. The pain is symmetric bilaterally and seems to improve after she starts working in the morning at her job in a local grocery store. She has also lost 10 pounds over the past 6 months despite no changes in her weight or exercise regimen. Her past medical history is notable for seasonal allergies, hypertension, and intermittent constipation. She takes losartan and a laxative as needed. She had adolescent idiopathic scoliosis as a child and underwent a spinal fusion at the age of 14. She does not smoke or drink alcohol. Her temperature is 98.6F 37C, blood pressure is 13575 mmHg, pulse is 92min, and respirations are 16min. On examination, she appears well and is appropriately interactive. Strength is 55 and sensation to light touch is intact in the bilateral upper and lower extremities. An examination of her hands demonstrates symmetric swelling of the metacarpophalangeal joints bilaterally. This patients condition is most strongly characterized by which of the following?? A: HLA-B27, B: HLA-B8, C: HLA-DR2, D: HLA-DR3, E: HLA-DR4,  <response>: This is a clinical vignette describing a 53-year-old woman with a 6-month history of progressive, symmetric, bilateral hand pain that improves with activity. She also has unintentional weight loss. On exam, she has swelling of the metacarpophalangeal joints. The description of inflammatory arthritis affecting the hands in a symmetric distribution along with morning stiffness improving with activity is classic for rheumatoid arthritis. Rheumatoid arthritis is strongly associated with the HLA-DR4 allele.The other HLA alleles listed are not characteristically associated with rheumatoid arthritis. HLA-B27 is associated with ankylosing spondylitis. HLA-B8 is associated with celiac disease. HLA-DR2 is associated with multiple sclerosis. HLA-DR3 is associated with type 1 diabetes mellitus.E: HLA-DR4 