Q1. A 33 yo Caucasian female presents with chief complaints of pain, fever, and swelling in multiple joints that make it difficult to type, lift or carry any items for the past 7 months. She has been experiencing morning stiffness and even tying shoe laces or buttoning her clothes is difficult. She has not been feeling well for several years and had used OTC medications for pain relief. She denies a rash, and has no allergies. The exam of her hands is shown below. Your immediate impression is that she has?
a. Osteoarthritis
b. Lupus
c. Psoriasis
d. Ankylosing spondylitis
e. Rheumatoid arthritis
f. Lyme disease
g. Sickle cell disease
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