<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 38-year-old woman comes to the physician because of a 1-month history of palpitations. She does not smoke or drink alcohol. Her pulse is 136min and irregularly irregular. An ECG shows irregularly spaced QRS complexes with no distinct P waves. Treatment is started with a drug that slows atrioventricular node conduction velocity and prevents voltage-dependent calcium entry into myocytes. The patient is at greatest risk for which of the following adverse effects?? A: Tinnitus, B: Dry mouth, C: Peripheral edema, D: Bronchospasm, E: Gingival hyperplasia,  <response>: This is a clinical vignette about a 38-year-old woman with a 1-month history of palpitations. The key findings are an irregularly irregular pulse, absence of P waves on ECG, and fast ventricular rate indicating atrial fibrillation. She is started on a medication that slows AV node conduction and blocks calcium channels, likely a calcium channel blocker like diltiazem or verapamil. The question asks about potential adverse effects of this medication. Choice A tinnitus is unrelated. Choice B dry mouth can occur due to anticholinergic effects. Choice C peripheral edema can occur due to vasodilation from CCBs. Choice D bronchospasm is not a typical side effect. Choice E gingival hyperplasia is a known adverse effect of calcium channel blockers like nifedipine due to their effects on gingival fibroblasts.Based on this analysis, choice E gingival hyperplasia is the most likely adverse effect of the calcium channel blocker therapy described.E: Gingival hyperplasia 