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A 59-year-old woman complains of pain and edema in the small joints of her hands, shortness of breath, weakness. This condition lasts for 8 years already. Objectively, her body temperature is $37.8^oC$, she has fine punctate hemorrhages on her torso and limbs, ulnar deviation of the hands is observed. The borders of the heart are shifted to the left, a systolic murmur can be detected over the apex. Her pulse is 96/min. Her blood pressure is 170/100 mm Hg. Complete blood count shows the following: erythrocytes --- $3.2 · 10^{12$/L, Hb --- 108 g/L, leukocytes --- $6.8 · 10^9$/L, platelets --- $220 · 10^9$/L, ESR --- 48 mm/hour, C-reactive protein (+++). General urinalysis shows the following: specific gravity --- 1016, protein --- 2.8 g/L, leukocytes --- 10--12 in the vision field, erythrocytes --- 2--4 in the vision field. What is the most likely diagnosis in this case?a.Chronic glomerulonephritisb.Rheumatoid art
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