<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 62-year-old man presents to the emergency department with hematuria and hemoptysis that started in the morning. He notes that he has had frequent lung infections throughout his adult life, the most recent being 2 weeks ago. He also mentions that he has had hematuria twice before but never as severe as he is having currently. His medical history is otherwise non-significant, and his only medication is acetaminophen as needed. His blood pressure is 13692 mm Hg, heart rate is 86min, respiratory rate is 16min, and temperature is 37.0C 98.6F. Chest radiography shows a resolving right middle lobe airspace opacity. His initial laboratory tests are notable for elevated erythrocyte sedimentation rate and C-reactive protein level. While in the examination room, the patient develops a spontaneous nosebleed. What is the most likely diagnosis?? A: Post-streptococcal glomerulonephritis, B: IgA nephropathy, C: Goodpasture syndrome, D: Minimal change disease, E: Granulomatosis with polyangiitis,  <response>: This is a patient with a history of recurrent lung infections who now presents with hematuria and hemoptysis. The key findings are recurrent lung infections, hematuria, hemoptysis, elevated inflammatory markers, and spontaneous nosebleed. This presentation is most consistent with a systemic autoimmune small vessel vasculitis such as granulomatosis with polyangiitis formerly known as Wegeners granulomatosis. Post-streptococcal glomerulonephritis, IgA nephropathy, minimal change disease are less likely given the lung involvement and elevated inflammatory markers. Goodpasture syndrome can present similarly with lung and kidney involvement but spontaneous nosebleeds are less common.E: Granulomatosis with polyangiitis 