<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 21-year-old African American woman presents with difficulty breathing, chest pain, and a non-productive cough. She says she took some ibuprofen earlier but it did not improve her pain. Past medical history is significant for sickle cell disease. Medications include hydroxyurea, iron, vitamin B12, and an oral contraceptive pill. She says she received a blood transfusion 6 months ago to reduce her Hgb S below 30. Her vital signs include: temperature 38.2C 100.7F, blood pressure 11271 mm Hg, pulse 105min, oxygen saturation 91 on room air. A chest radiograph is performed and is shown in the exhibit. Which of the following is best initial step in the management of this patients condition?? A: Antibiotics and supportive care, B: ECG, C: CT angiography, D: Inhaled salbutamol and oral corticosteroid, E: Intra-articular corticosteroid injection with anesthetic,  <response>: This is a patient with sickle cell disease presenting with acute symptoms of chest pain, cough, and hypoxemia. The description and chest X-ray are consistent with an acute pain crisis and acute chest syndrome. The initial management should focus on treating the acute pain crisis, improving oxygenation, preventing further sickling, and covering for possible infection. Choice A for antibiotics and supportive care is reasonable to cover infection and manage symptoms. Choice B for ECG is less relevant as this is likely a vaso-occlusive crisis. Choice C for CT angiography may be indicated later if pulmonary embolism is suspected but is not the most urgent initial step. Choices D and E may help with symptom management but do not address the underlying acute pain crisis and hypoxemia.A: Antibiotics and supportive care 