<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 emergency department for the evaluation of a headache and increased sweating for the last two hours. The patient also reports palpitations and nausea. Yesterday, she was started on venlafaxine for treatment-resistant depression. She took citalopram for four weeks, but stopped three days ago because her symptoms of depression did not improve. She does not smoke or drink alcohol. Her temperature is 39C 102.2F, pulse is 120min, and blood pressure is 15090 mm Hg. On mental status examination, the patient is only oriented to person, but not to place or time. Examination shows tremors in all extremities. She has impaired gait. Deep tendon reflexes are 3 bilaterally. Which of the following is the most likely cause of this patients symptoms?? A: Abnormal ryanodine receptor, B: Increased CNS serotonergic activity, C: Dopamine receptor blockade, D: Anticholinergic toxicity, E: Suspected amphetamine intake,  <response>: This is a clinical vignette describing a patient who recently started venlafaxine and stopped citalopram, and now presents with fever, tachycardia, hypertension, altered mental status, tremors, and hyperreflexia. The key details are:- Recently started venlafaxine and stopped citalopram - High fever, fast heart rate, high blood pressure- Altered mental status, tremors, hyperreflexiaThis presentation is most consistent with serotonin syndrome, which can occur when there is excessive serotonin activity in the central nervous system. The patient was recently started on venlafaxine, a serotonin-norepinephrine reuptake inhibitor, while also stopping citalopram, a selective serotonin reuptake inhibitor. This likely led to excessive serotonin levels. The other answer choices can be ruled out:- Abnormal ryanodine receptor would not cause these symptoms- Dopamine receptor blockade would cause the opposite of tremors - Anticholinergic toxicity would cause dry skinmucous membranes, not sweating- Amphetamine intake would not cause hyperreflexiaB: Increased CNS serotonergic activity 