<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 25-year-old man is scheduled for an orthopedic surgery. His routine preoperative laboratory tests are within normal limits. An urticarial reaction occurs when a non-depolarizing neuromuscular blocking agent is injected for muscle relaxation and mechanical ventilation. The patients lungs are manually ventilated with 100 O2 by bag and mask and then through an endotracheal tube. After a few minutes, edema of the face and neck rapidly ensues and giant hives appear over most of his body. Which of the following neuromuscular blocking agents was most likely used in this operation?? A: Succinylcholine, B: Neostigmine, C: D-tubocurarine, D: Nitrous oxide, E: Ketamine,  <response>: This is a clinical vignette describing a patient who experienced an urticarial reaction after being given a non-depolarizing neuromuscular blocking agent prior to surgery. The reaction included edema of the face and neck as well as giant hives over most of the body. The question asks which neuromuscular blocking agent was most likely used. Based on the description, it seems the patient had an allergic or anaphylactoid reaction to the neuromuscular blocker. Of the choices provided, succinylcholine is a depolarizing agent so it can be ruled out. Neostigmine is an anticholinesterase agent used to reverse neuromuscular blockade, not cause it, so it can also be eliminated. Nitrous oxide and ketamine are anesthetic agents, not neuromuscular blockers, so they do not fit the scenario either. The remaining choice, d-tubocurarine, is a classic non-depolarizing neuromuscular blocking agent that has been associated with allergic reactions like the one described. Therefore, d-tubocurarine is the most likely agent used.C: D-tubocurarine 