<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 68-year-old man comes to the physician in July for a routine health maintenance examination. He is a retired teacher and lives in a retirement community. He has hypercholesterolemia, hypertension, and osteoarthritis of the left knee. Last year, he was diagnosed with chronic lymphocytic leukemia. A colonoscopy 8 years ago was normal. The patient had a normal digital examination and a normal prostate specific antigen level 8 months ago. The patient has never smoked and does not drink alcohol. Current medications include aspirin, lisinopril, simvastatin, chlorambucil, rituximab, and a multivitamin. His last immunizations were at a health maintenance examination 7 years ago. His temperature is 37C 98.6F, pulse is 82min, respirations are 14min, and blood pressure is 13385 mm Hg. Examination shows a grade 26 systolic ejection murmur along the upper right sternal border and painless cervical lymphadenopathy. Which of the following health maintenance recommendations is most appropriate at this visit?? A: Pneumococcal conjugate vaccine 13, B: Abdominal ultrasound, C: Meningococcal conjugate vaccine, D: Varicella vaccine, E: Influenza vaccine,  <response>: This is a question about appropriate health maintenance recommendations for a 68-year-old man with multiple medical conditions. The key points from the stem are:- 68-year-old man- History of hypercholesterolemia, hypertension, osteoarthritis, chronic lymphocytic leukemia - Normal colonoscopy 8 years ago- Never smoked, does not drink alcohol- On multiple medications including chlorambucil and rituximab for CLL- Last immunizations were 7 years ago- Physical exam shows murmur and lymphadenopathyThe choices include different vaccine options as well as an abdominal ultrasound. For a man of this age, the most important vaccine recommendation would likely be the pneumococcal vaccines to prevent bacterial pneumonia. The influenza vaccine is also important given his age. Meningococcal and varicella vaccines are less relevant. Abdominal ultrasound is not a routine recommendation.A: Pneumococcal conjugate vaccine 13 