<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 62-year-old woman presents to the office because she has noticed yellowish bumps and patches on her elbows and knees that seem to come and go. Recently she noticed the same yellow bumps on her eyelids. She is a new patient and reports that she is otherwise healthy but did not have insurance until recently so she has not been to the doctor in over 8 years. Past medical history is significant for occasional headaches that she treats with aspirin. She used to smoke a pack a day for the last 20 years but recently quit. Her father died of a heart attack at the age of 55 years and her mother had a stroke at 64 and lives in a nursing home. Her blood pressure is 13587 mm Hg, the heart rate is 95min, the respiratory rate is 12min, and the temperature is 37.0C 98.6F. On physical exam, she has multiple tan-yellow, firm papules on her knees and elbows. The papules around her eyes are smaller and soft. You discuss the likely cause of the bumps and explain that you will need to order additional tests. What test should you perform?? A: Biopsy, B: PET scan, C: Celiac panel, D: Lipid panel, E: Erythrocyte sedimentation rate ESR,  <response>: This is a question about choosing the appropriate diagnostic test for a patient presenting with yellowish bumps and patches on her elbows, knees, and eyelids. The key findings in the stem are the description of the lesions, the patients age, lack of regular medical care, smoking history, family history, and vital signs. The differential diagnosis based on the clinical presentation includes xanthomas which can be associated with underlying lipid abnormalities. A lipid panel would be the appropriate initial test to evaluate for hyperlipidemia which can cause xanthomas. A biopsy may be needed later to confirm the diagnosis but is not the first step. PET scan, celiac panel, and ESR are not indicated based on the clinical presentation.D: Lipid panel 