<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 71-year-old African American man is brought to the emergency department with sudden onset lower limb paralysis and back pain. He has had generalized bone pain for 2 months. He has no history of severe illnesses. He takes ibuprofen for pain. On examination, he is pale. The vital signs include: temperature 37.1C 98.8F, pulse 68min, respiratory rate 16min, and blood pressure 15590 mm Hg. The neurologic examination shows paraparesis. The 8th thoracic vertebra is tender to palpation. X-ray of the thoracic vertebrae confirms a compression fracture at the same level. The laboratory studies show the following:Laboratory testHemoglobin 9 gdLMean corpuscular volume 95 μm3Leukocyte count 5,000mm3Platelet count 240,000mm3ESR 85 mmhrSerumNa 135 mEqLK 4.2 mEqLCl 113 mEqLHCO3 20 mEqLCa 11.8 mgdLAlbumin 4 gdLUrea nitrogen 38 mgdLCreatinine 2.2 mgdLWhich of the following is the most likely mechanism underlying this patients vertebral fracture?? A: Acidosis-induced bone lysis, B: Bone demineralization, C: Increased mechanical pressure, D: Increased osteoblastic activity, E: Proliferation of tumor cells,  <response>: This is a clinical vignette describing a 71-year-old African American man presenting with sudden lower limb paralysis, back pain, and a compression fracture of the T8 vertebra. The key findings are:- Sudden onset lower limb paralysis and back pain- 2 month history of generalized bone pain - Tender T8 vertebra with compression fracture on x-ray- Anemia, leukopenia, thrombocytopenia- High ESR- Hypercalcemia- Renal insufficiency This constellation of findings is most consistent with multiple myeloma resulting in a pathologic vertebral fracture. The anemia, renal failure, hypercalcemia, and bone lesions are classic manifestations of multiple myeloma. The proliferating plasma cells produce cytokines that activate osteoclasts, leading to osteolytic lesions and pathologic fractures.E: Proliferation of tumor cells 