<s>[INST] context: Rheumatoid ahritis (RA) is a chronic, systemic autoimmune disease that involves inflammation in the membrane lining of the joints and often affects internal organs. Most patients exhibit a chronic fluctuating course of disease that can result in progressive joint destruction, deformity, and disability. RA affects between 1 and 2 million Americans. It occurs three times more often in women, and peaks at age 35 to 50 years. Signs & Symptoms of RA Fatigue. Stiffness, especially in early morning and after sitting a long period of time. Not relieved by pain Low Grade Fever, Weakness. Muscle pain and pain with prolonged sitting. Symmetrical, affects joints on both sides of the body. Rheumatoid nodules. Deformity of your joints over time. Raynauds phenomenon. Pain Treatment objectives The goals in the management of RA are: 1. To prevent or control joint damage 2. To prevent loss of function 3. To decrease pain 4. To maintain the patient&;s quality of life 5. To avoid or minimize adverse effects of treatment. 6. Preservation of muscle and joint function. 7. Return to a desirable and productive life. ref : maheswari 7th ed [/INST] question: Patient is presenting with deformity of the finger as shown The PIP is involved but DIP is spared | options: A: osteoahritis B: Rheumatoid ahritis C: Psoriatic ahritis D: Ankylosing spondylitis | answer: B </s>