<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 30-year-old forest landscape specialist is brought to the emergency department with hematemesis and confusion. One week ago she was diagnosed with influenza when she had fevers, severe headaches, myalgias, hip and shoulder pain, and a maculopapular rash. After a day of relative remission, she developed abdominal pain, vomiting, and diarrhea. A single episode of hematemesis occurred prior to admission. Two weeks ago she visited rainforests and caves in western Africa where she had direct contact with animals, including apes. She has no history of serious illnesses or use of medications. She is restless. Her temperature is 38.0C 100.4F; the pulse is 95min, the respiratory rate is 20min; and supine and upright blood pressure is 13070 mm Hg and 10065 mm Hg, respectively. Conjunctival suffusion is noted. Ecchymoses are observed on the lower extremities. She is bleeding from one of her intravenous lines. The peripheral blood smear is negative for organisms. Filovirus genomes were detected during a reverse transcription-polymerase chain reaction. The laboratory studies show the following:Laboratory testHemoglobin 10 gdLLeukocyte count 1,000mm3Segmented neutrophils 65Lymphocytes 20Platelet count 50,000mm3Partial thromboplastin time activated 60 secondsProthrombin time 25 secondsFibrin split products positiveSerum Alanine aminotransferase ALT 85 ULAspartate aminotransferase AST 120 ULγ-Glutamyltransferase GGT 83 ULCreatinine 2 mgdLWhich of the following is the most appropriate immediate step in management?? A: Esophagogastroduodenoscopy, B: Intravenous fluids and electrolytes, C: Parenteral artesunate plus sulfadoxinepyrimethamine, D: Postexposure vaccination of close contacts, E: Use of N95 masks,  <response>: This is a question about the appropriate management of a patient with suspected viral hemorrhagic fever. The key findings in the stem are:- 30 year old woman with recent travel to Africa and animal exposure - Presented with flu-like symptoms initially, now with hematemesis, thrombocytopenia, coagulopathy, and hypotension suggestive of viral hemorrhagic fever- PCR positive for filovirus suggesting Ebola or Marburg virus as the likely causeThe immediate priorities in a patient with suspected viral hemorrhagic fever and hemorrhage are hemodynamic stabilization and limiting further exposure. Endoscopy would not be appropriate in an unstable patient and could increase risk of transmission. Malaria treatment is not indicated with negative blood smears and positive filovirus PCR. Postexposure prophylaxis for contacts can be addressed later. N95 masks help limit transmission but do not address the patients critical needs.Therefore, the most appropriate immediate step is intravenous fluids and electrolytes to stabilize the patient hemodynamically.B: Intravenous fluids and electrolytes 