<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 33-year-old woman comes to the physician because of a 3-week history of fatigue and worsening shortness of breath on exertion. There is no family history of serious illness. She does not smoke. She takes diethylpropion to control her appetite and, as a result, has had a 4.5-kg 10-lb weight loss during the past 5 months. She is 163 cm 5 ft 4 in tall and weighs 115 kg 254 lb; BMI is 44 kgm2. Her pulse is 83min and blood pressure is 12585 mm Hg. Cardiac examination shows a loud pulmonary component of the S2. Abdominal examination shows no abnormalities. Which of the following is the most likely underlying cause of this patients shortness of breath?? A: Hypertrophy of interventricular septum, B: Hyperplasia of pulmonary vascular walls, C: Blockade of the right bundle branch, D: Fibrosis of pulmonary interstitium, E: Calcification of the pulmonary valve,  <response>: This is a medical case question involving a 33-year-old obese woman with a 3-week history of fatigue and worsening shortness of breath on exertion. There is no family history of serious illness and she does not smoke. She has been taking a weight loss medication diethylpropion and has lost 10 lbs in the past 5 months. Her vital signs show tachycardia and borderline hypertension. The cardiac exam reveals a loud P2, suggesting pulmonary hypertension.Based on the clinical history and exam findings, the most likely underlying cause of her shortness of breath is pulmonary hypertension secondary to obesityweight loss medication use. Choices A, C, and E can be eliminated as they do not explain her symptoms. Choice D pulmonary fibrosis may cause shortness of breath but there is no evidence to support this diagnosis. Choice B hyperplasia of pulmonary vascular walls is the best answer, as this is the pathological process seen in pulmonary hypertension.B: Hyperplasia of pulmonary vascular walls 