<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 57-year-old female presents to her primary care physician with a chief complaint of feeling tired all the time. She states her symptoms began several months ago, around the time that her husband committed suicide. Since then she has had thoughts of joining her husband. She complains of feeling excessively weak and states that she no longer has enough energy to go to the gym which she attributes to her 15 pound weight gain over the last month. The patients medical history includes joint pain, a skin rash that recently resolved, obstructive sleep apnea, and metabolic syndrome. The patient takes ibuprofen and omeprazole as needed but otherwise cannot remember any other medications that she takes. On physical exam you note an overweight woman who has an overall depressed affect. The patients cardiac exam reveals a normal rate and rhythm. The pulmonary exam reveals bilateral clear lung fields with good air movement. The patients skin is very dry and tight appearing and her hair is coarse. Overall the patient appears somewhat unkempt.Laboratory work is performed and reveals the following:Hemoglobin: 13.0 gdLHematocrit: 37Leukocyte count: 4,500 cellsmm3 with normal differentialPlatelets: 250,000mm3Serum:Na: 140 mEqLK: 4.4 mEqLCl-: 102 mEqLBUN: 15 mgdLGlucose: 122 mgdLCreatinine: 1.0 mgdLThyroid-stimulating hormone: 5.3 μUmLCa2: 10.2 mgdLAST: 11 ULALT: 13 ULWhich of the following laboratory findings is most likely to be abnormal in this patient?? A: Anti-DNA topoisomerase antibodies, B: Anti-nuclear antibodies, C: Anti-histidyl-tRNA synthetase antibodies, D: Anti-thyroid peroxidase antibodies, E: 5-hydroxyindoleacetic acid in CSF,  <response>: Based on the patients symptoms of fatigue, weight gain, dry skin, coarse hair, and elevated TSH level, the most likely diagnosis is hypothyroidism. The question is asking which additional laboratory test would be most likely to be abnormal in this patient with suspected hypothyroidism.Choice A and C are tests for autoimmune diseases and are less likely to be relevant. Choice B, ANA, can be elevated in autoimmune thyroiditis but is less specific than choice D. Choice D, anti-TPO antibodies, are commonly elevated in autoimmune hypothyroidism such as Hashimotos thyroiditis. This is the most likely antibody to be abnormal in a patient with suspected hypothyroidism.Choice E tests serotonin metabolite levels and is unrelated to hypothyroidism.D: Anti-thyroid peroxidase antibodies 