<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 51-year-old man comes to the physician for the evaluation of a 3-week history of fatigue and shortness of breath. One year ago, a screening colonoscopy showed colonic polyps. His brother has a bicuspid aortic valve. On examination, a late systolic crescendo-decrescendo murmur is heard at the right upper sternal border. Laboratory studies show:Hemoglobin 9.1 gdLLDH 220 ULHaptoglobin 25 mgdL N 41165 mgdLUrea nitrogen 22 mgdLCreatinine 1.1 mgdLTotal bilirubin 1.8 mgdLA peripheral blood smear shows schistocytes. Which of the following is the most likely cause of this patients anemia?? A: Gastrointestinal bleeding, B: Autoimmune destruction of erythrocytes, C: Erythrocyte membrane fragility, D: Fragmentation of erythrocytes, E: Erythrocyte enzyme defectn,  <response>: Based on the information provided in the question stem, the key findings are:- 51-year-old man with 3-week history of fatigue and shortness of breath - Colon polyps found on colonoscopy 1 year ago- Brother has bicuspid aortic valve- Late systolic murmur on exam- Lab findings: low hemoglobin, elevated LDH, low haptoglobin, presence of schistocytes on peripheral smearThe low hemoglobin, elevated LDH, low haptoglobin and presence of schistocytes indicate intravascular hemolysis. The murmur and family history of bicuspid aortic valve raise suspicion for aortic stenosis as the cause. Therefore, the fragmentation of erythrocytes due to turbulent flow across the stenotic aortic valve is the most likely cause of this patients anemia.D: Fragmentation of erythrocytes 