<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 26-year-old man presents into the emergency department complaining of hemoptysis for the past day. He has also experienced fatigue, weight loss 10 kg 22 lb over the last 2 months, and occasional dry cough. He is a college student and works part-time as a cashier in a bookstore. He is sexually active with his girlfriend and uses condoms occasionally. He smokes 23 cigarettes on weekends and denies alcohol use. Today, his pulse is 97min, the blood pressure is 12876 mm Hg, the temperature is 36.7C 98.0F. On physical exam, the patient is well developed with mild gynecomastia. His heart has a regular rate and rhythm. Lung examination reveals vesicular sounds with occasional crepitations bilaterally. and his lungs are clear to auscultation bilaterally. The abdominal exam is non-contributory. His right testicle is tender and larger than the left. The swelling does not transilluminate and does not change in size after performing a Valsalva maneuver. His laboratory work is positive for elevated levels of beta-HCG. What is the most likely diagnosis in this patient?? A: Orchitis, B: Inguinal hernia, C: Spermatocele, D: Testicular malignancy, E: Hydrocele,  <response>: Based on the information provided in the question stem, the key findings are:- 26-year-old male presenting with hemoptysis, fatigue, weight loss, and dry cough- Sexually active with girlfriend, uses condoms occasionally- Smokes cigarettes occasionally - Physical exam shows mild gynecomastia, tender and enlarged right testicle- Lab work shows elevated beta-HCGThe symptoms of hemoptysis, fatigue, weight loss, and cough point towards a pulmonary process like tuberculosis or lung cancer. The enlarged, tender testicle along with elevated beta-HCG is highly suspicious for testicular cancer with metastasis. Of the choices given, testicular malignancy best fits the clinical presentation.D: Testicular malignancy 