question: Q:A 45-year-old woman presents to the clinic for a routine examination. She has a chronic history of systemic lupus erythematosus, diagnosed at age 27. Medications include hydroxychloroquine and low-dose prednisone. She has had no recent flare-ups and is compliant with her medication. Anticardiolipin and anti-beta-2 glycoprotein-1 antibodies are negative, and she has had no history of thrombi or emboli. Physical examination is normal except for mild bilateral tenderness and swelling of the knees. Creatinine and GFR are normal. Which of the following is the next best step in management to monitor disease activity?? 
  {'A': 'Urinalysis and renal biopsy', 'B': 'Anti-dsDNA antibody levels', 'C': 'Anti-Smith antibody levels', 'D': 'Reduce dosage and taper off hydroxychloroquine', 'E': 'Arthrocentesis and synovial fluid analysis'},