<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 54-year-old man presents to the emergency department after vomiting blood an hour ago. He says this happens to him occasionally but denies feeling pain in these episodes. The man is disheveled and has slurred speech as he describes his symptoms. He is reluctant to give further history and wants immediate treatment of his condition. Upon examination, the patient has evidence of tortuous veins visible on his abdomen plus a yellow tinge to his sclerae. He suddenly begins vomiting copious amounts of blood and soon becomes unresponsive. His blood pressure drops to 7040 mm Hg. He is given 3 units of whole blood but passes away shortly after the incident. Which of the following was the most likely cause of his vomiting of blood?? A: Increased pressure in the distal esophageal vein due to increased pressure in the left gastric vein, B: Lacerations of the mucosa at the gastroesophageal junction, C: Perforation of the gastric mucosa, D: Decreased GABA activity due to downregulation of receptors, E: Inflammation of the portal tract due to a chronic viral illness,  <response>: Based on the description in the question stem, the patient is a 54-year-old man with a history of recurrent vomiting of blood. Key findings on exam include tortuous abdominal veins, yellow sclerae, slurred speech, and disheveled appearance. He then has a massive episode of vomiting blood and dies shortly after despite blood transfusion. The yellow sclerae and tortuous abdominal veins point to liver disease as a likely cause. The recurrent vomiting of blood suggests esophageal varices as the source, which often occur in liver cirrhosis due to portal hypertension. The slurred speech and disheveled appearance also fit with chronic liver disease. The massive bleeding episode leading to death confirms a variceal source as most likely.A: Increased pressure in the distal esophageal vein due to increased pressure in the left gastric vein 