Rheumatoid arthritis and osteoarthritis Quiz: Ace Your Exams

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A 58-year-old woman is brought to the emergency department because of shortness of breath and productive cough. The symptoms began one day ago. She reports producing yellowish, non-bloody sputum. Past medical history is notable for rheumatoid arthritis. Temperature is 38.7°C (101.7°F), blood pressure is 130/82 mmHg, and pulse is 75/min. Pulmonary examination reveals decreased breath sounds in the left lower lung. Examination of the hands reveals swelling and mild deformation of the bilateral metacarpophalangeal and proximal interphalangeal joints. Abdominal examination is notable for splenomegaly. Laboratory results are as follows:

 
 Laboratory value  Result 
 Complete blood count 
 Hemoglobin   10 g/dL 
 Platelets   400,000/mm3 
 Erythrocyte sedimentation rate  84 mm/h 

The sputum shows Gram-positive staining. Which of the following additional laboratory findings will most likely be present in the patient?

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