<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 76-year-old woman comes in for a routine checkup with her doctor. She is concerned that she feels tired most days and has difficulty doing her household chores. She complains that she gets fatigued and breathless with mild exertion. Past medical history is significant for diabetes mellitus, chronic kidney disease from prolonged elevated blood sugar, and primary biliary cirrhosis. Medications include lisinopril, insulin, and metformin. Family medicine is noncontributory. She drinks one beer every day. Today, she has a heart rate of 98min, respiratory rate of 17min, blood pressure of 11065 mm Hg, and a temperature of 37.0C 98.6F. General examination shows that she is pale and haggard looking. She has a heartbeat with a regular rate and rhythm and her lungs are clear to auscultation bilaterally. A complete blood count CBC is as follows:Leukocyte count: 12,000mm3Red blood cell count: 3.1 millionmm3Hemoglobin: 11.0 gdLMCV: 85 um3MCH: 27 pgcellPlatelet count: 450,000mm3Fecal occult blood test is negative. What is the most likely cause of her anemia?? A: Chronic kidney disease, B: Acute bleeding, C: Alcoholism, D: Liver disease, E: Colorectal cancer,  <response>: Based on the information provided in the question stem, this 76-year-old woman has a history of diabetes mellitus, chronic kidney disease, and primary biliary cirrhosis. She is presenting with fatigue, shortness of breath, and pallor which are concerning for anemia. Her CBC shows a low RBC count and hemoglobin level confirming anemia. The MCV is normal, indicating a normocytic anemia. There is no evidence of acute bleeding based on a normal platelet count and negative fecal occult blood test. Her chronic kidney disease is the most likely cause of her anemia, as kidney disease can lead to decreased erythropoietin production and cause anemia. Alcoholism and colorectal cancer are less likely given her negative history and normal MCV. Her liver disease could contribute but her kidney disease is the most direct explanation.A: Chronic kidney disease 