<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 45-year-old man presents an urgent care clinic because he coughed up blood this morning. Although he had a persistent cough for the past 3 weeks, he had never coughed up blood until now. His voice is hoarse and admits that it has been like that for the past few months. Both his past medical history and family history are insignificant. He has smoked a pack of cigarettes a day since the age of 20 and drinks wine every night before bed. His vitals are: heart rate of 78min, respiratory rate of 14min, temperature of 36.5C 97.8F, blood pressure of 14088 mm Hg. An indirect laryngoscopy reveals a rough vegetating lesion on the free border of the right vocal cord. Which of the following is the most likely diagnosis?? A: Acute laryngitis, B: Leukoplakia, C: Polypoid corditis, D: Vocal cord nodule, E: Laryngeal carcinoma,  <response>: Based on the information provided in the question stem, the key findings are:- 45-year-old man with 3 week history of persistent cough, now with hemoptysis- Hoarse voice for past few months- Significant smoking history 1 pack per day for 25 years - Indirect laryngoscopy showed rough vegetating lesion on vocal cordThe hoarseness, hemoptysis, and vocal cord lesion point towards a malignant process like laryngeal carcinoma rather than an infectious or benign cause. The 25 pack-year smoking history is a major risk factor for laryngeal carcinoma.E: Laryngeal carcinoma 