<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 39-year-old man presents to his primary care physician with new onset lower extremity edema, fatigue, and hematuria. His symptoms began approximately 2 weeks prior to presentation and have progressively worsened. Medical history is significant for opioid-use disorder with heroin treated with methadone. He is in a monogamous relationship with a female partner of 4 years and does not use condoms. He denies cigarette smoking, alcohol use, and last used heroin approximately 1 month ago. His temperature is 99F 37.2C, blood pressure is 15298 mmHg, pulse is 83min, and respirations are 17min. On physical exam, there is conjunctival pallor, scleral icterus, a 14 cm liver span, acrocyanosis, and lower extremity 2 pitting edema. Urinalysis demonstrates proteinuria and dysmorphic red blood cells. Laboratory testing reveals a mildly decreased C3 and decreased C4 serum concentration. Which of the following will most likely be present on renal biopsy in this patient?? A: Apple-green birefringence on Congo red stain, B: Diffuse mesangial cell proliferation with capillary wall thickening, C: Enlarged and hypercellular glomeruli, D: Glomerular basement membrane thinning and splitting, E: Normal appearing glomerulus,  <response>: This is a clinical vignette describing a 39-year-old man with new onset lower extremity edema, fatigue, hematuria, and laboratory findings consistent with a glomerular disease. The question asks which renal biopsy finding is most likely in this patient.The key findings in the vignette are:- New onset lower extremity edema, fatigue, hematuria - History of IV drug use heroin- Physical exam findings of pallor, icterus, hepatomegaly, acrocyanosis, lower extremity edema- Urinalysis showing proteinuria and RBC casts- Low C3 and C4 - No other significant medical history The low complement levels point towards some type of glomerulonephritis. The IV drug use history raises suspicion for hepatitis C associated cryoglobulinemic glomerulonephritis. This type of glomerulonephritis classically shows a membranoproliferative pattern on biopsy, with glomerular basement membrane immune complex deposits. Of the choices given, Diffuse mesangial cell proliferation with capillary wall thickening would be most consistent with a membranoproliferative glomerulonephritis, and therefore most likely in this clinical scenario.B: Diffuse mesangial cell proliferation with capillary wall thickening 