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174829 Medicine

A 35-year-old woman complains of aching all over. She sleeps poorly and all her muscles and joints hurt. Her symptoms have progressed over several years. She reports that she is desperate because pain and weakness often cause her to drop things. Physical examination shows multiple points of tenderness over the neck, shoulders, elbows, and wrists. There is no joint swelling or deformity. A complete blood count and ESR are normal. Rheumatoid factor is negative. Which of the following is the best therapeutic option in this patient?

AGraded aerobic exercise
BPrednisone
CWeekly methotrexate
DHydroxychloroquine
Medicine
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