The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 55-year-old man presents with bloody nasal secretions and shortness of breath. He reports he has lost 4 kg (8.8 lb) in the last two months with no changes in his diet. He has also been suffering from mild to moderate joint pain in the left knee for the last year. His past medical history is unremarkable. His vitals include: blood pressure 120/70 mm Hg, temperature 37.0℃ (98.6℉), pulse 70/min, respiratory rate 14/min. Physical examination is significant for nasal ulcers. Diffuse crackles are present over all lobes of the lung bilaterally. Laboratory findings are significant for the following: Hemoglobin 12.9 g/dL Hematocrit 37.7% Leukocyte count 5500/mm3 Neutrophils 65% Lymphocytes 30% Monocytes 5% Mean corpuscular volume 82.2 μm3 Platelet count 190,000/mm3 Erythrocyte sedimentation rate 35 mm/h C-reactive protein 14 mg/dL Creatinine 3.09 mg/dL The patient is prescribed a corticosteroid nasal spray and oral antibiotics but returns in 2 weeks without any clinical improvement. Which of the following would most likely confirm the diagnosis in this patient?   (A) Anti-citrullinated protein antibodies   (B) Erythrocyte sedimentation rate   (C) Anti-histone bodies   (D) Antineutrophil cytoplasmic antibodies
['(D) Antineutrophil cytoplasmic antibodies <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Anti-citrullinated protein antibodies \n (B) Erythrocyte sedimentation rate \n (C) Anti-histone bodies \n (D) Antineutrophil cytoplasmic antibodies <> possible answers', '  A 55-year-old man presents with bloody nasal secretions and shortness of breath. He reports he has lost 4 kg (8.8 lb) in the last two months with no changes in his diet. He has also been suffering from mild to moderate joint pain in the left knee for the last year. His past medical history is unremarkable. His vitals include: blood pressure 120/70 mm Hg, temperature 37.0℃ (98.6℉), pulse 70/min, respiratory rate 14/min. Physical examination is significant for nasal ulcers. Diffuse crackles are present over all lobes of the lung bilaterally. Laboratory findings are significant for the following:\nHemoglobin 12.9 g/dL\nHematocrit 37.7%\nLeukocyte count 5500/mm3\nNeutrophils 65%\nLymphocytes 30%\nMonocytes 5%\nMean corpuscular volume 82.2 μm3\nPlatelet count 190,000/mm3\nErythrocyte sedimentation rate 35 mm/h\nC-reactive protein 14 mg/dL\nCreatinine 3.09 mg/dL\nThe patient is prescribed a corticosteroid nasal spray and oral antibiotics but returns in 2 weeks without any clinical improvement. Which of the following would most likely confirm the diagnosis in this patient? <> context@']