<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 47-year-old woman presents to a local medical shelter while on a mission trip with her church to help rebuild homes after a hurricane. She has been experiencing severe nausea, vomiting, and diarrhea for the last 2 days and was feeling too fatigued to walk this morning. On presentation, her temperature is 99.2F 37.3C, blood pressure is 9562 mmHg, pulse is 121min, and respirations are 17min. Physical exam reveals decreased skin turgor, and a stool sample reveals off-white watery stools. Gram stain reveals a gram-negative, comma-shaped organism that produces a toxin. Which of the following is consistent with the action of the toxin most likely involved in the development of this patients symptoms?? A: Activation of receptor tyrosine kinase, B: Cleavage of junctional proteins, C: Decreased ribosomal activity, D: Increased adenylyl cyclase activity, E: Increased membrane permeability,  <response>: This is a clinical vignette describing a patient with symptoms of severe nausea, vomiting, diarrhea, fatigue, fever, hypotension, tachycardia, and decreased skin turgor, along with laboratory findings of watery diarrhea and identification of gram-negative comma-shaped bacteria. The key finding is identification of a gram-negative comma-shaped organism in the stool that produces a toxin. This clinical presentation is most consistent with cholera, caused by Vibrio cholerae. The cholera toxin increases intracellular cAMP levels by activating adenylyl cyclase, which results in increased chloride and bicarbonate secretion into the intestinal lumen. This leads to the large volume watery diarrhea seen in cholera. D: Increased adenylyl cyclase activity 