<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 33-year-old woman presents to her primary care physician for gradually worsening pain in both wrists that began several months ago. The pain originally did not bother her, but it has recently begun to affect her daily functioning. She states that the early morning stiffness in her hands is severe and has made it difficult to tend to her rose garden. She occasionally takes ibuprofen for the pain, but she says this does not really help. Her medical history is significant for diabetes mellitus and major depressive disorder. She is currently taking insulin, sertraline, and a daily multivitamin. The vital signs include: blood pressure 12684 mm Hg, heart rate 82min, and temperature 37.0C 98.6F. On physical exam, her wrists and metacarpophalangeal joints are swollen, tender, erythematous, and warm to the touch. There are no nodules or vasculitic lesions. Which of the following antibodies would be most specific to this patients condition?? A: Anti-Ro, B: Rheumatoid factor, C: Anti-Scl-70, D: c-ANCA, E: Anti-cyclic citrullinated peptide,  <response>: This is a clinical vignette describing a patient with gradually worsening wrist pain and morning stiffness. The history and physical exam findings of swollen, tender, erythematous, warm joints suggest an inflammatory arthritis. The question asks about the most specific antibody for this patients condition. Based on the presentation, the most likely diagnosis is rheumatoid arthritis. Rheumatoid factor and anti-cyclic citrullinated peptide anti-CCP antibody are both associated with rheumatoid arthritis. However, anti-CCP is more specific for rheumatoid arthritis. Anti-Ro, anti-Scl-70, and c-ANCA are associated with other autoimmune conditions lupus, scleroderma, and vasculitis, respectively, not rheumatoid arthritis.E: Anti-cyclic citrullinated peptide 