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[Expert Solution]: History and Physical Ronald B, a…

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History and Physical Ronald B, a 37-year-old male sought medical attention because of fatigue, persistant pain in his wrists and ankles and unexplained weight loss. On physical examination, swelling of the joints of the hands and ankles was evident. Laboratory Data CBC, UA, and RA screening test were ordered, with the following results: • Hemoglobin and hematocrit—normal • Total leukocyte count—70 × 10 9/L • Differential leukocyte count—normal • Gross and microscopic UA—normal • RA screening test—positive Follow-Up An ANA screening test was ordered. The results were positive with a nucleolar pattern DISCUSS THE CASE WITH YOUR TEAM MATES and BE PREPARED TO ANSWER QUESTIONS FROM YOUR COLLEAGUES Suggested topics to include in your discussion: (This list is not all inclusive) Group Discussion Questions 1. What is the most probable diagnosis in this case? 2. Specifically, what is ‘rheumatoid factor’ and how is it detected in laboratory assays? 2. Does this patient fit into the general characteristics of patients with this disease? 3. What is the principle of the ANA test? 4. Explain the various nuclear staining patterns and how the nucleolar pattern relates to this diagnosis.

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