a 45-year-old Female Patient Presents with Joint Pain, Swelling and Stiffness in Her Hands, Wrists and Knees. She Also Complains of Fatigue and Occasional Low-grade Fever. on Physical Examination, the Nurse Notes Symmetrical Joint Swelling and Tenderness. the Patient’s Laboratory Results Show Elevated Levels of Rheumatoid Factor and Anti-cyclic Citrullinated Peptide (Anti-ccp) Antibodies