A 23-Year-Old Woman Comes to the Office Due to Sharp

A 23-year-old woman comes to the office due to sharp, right-sided chest pain, fatigue, and fever for the past week.  The chest pain is worsened with deep breathing.  She has had no associated expectoration or shortness of breath.  For the past 6 months, the patient also has had intermittent joint pains, predominantly in the knees and hands.  She is sexually active with one male partner and uses an intrauterine device for contraception.  Temperature is 38.3 C (100.9 F) , blood pressure is 120/70 mm Hg, pulse is 89/min, and respirations are 18/min.  BMI is 24 kg/m².  Examination shows mild erythema over the cheeks and a scratching sound over the right lower lung with breathing.  Heart sounds are normal.  There is no joint swelling.  Which of the following tests is most useful in confirming the diagnosis?

A) Anti-double-stranded DNA antibodies
B) Antistreptolysin O titers
C) Nucleic acid amplification test of cervical swab
D) Rheumatoid factor assay
E) Serologic test for syphilis

Correct Answer:

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