<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 60-year-old man comes to the physician because of progressive pain in his right hip and lower back over the past 4 weeks. He describes the pain as dull and constant. It is worse with exertion and at night. Over the past 2 months, he has helped his son with renovating his home, which required heavy lifting and kneeling. His father died of prostate cancer. He drinks 23 beers daily. Vital signs are within normal limits. Examination shows localized tenderness over the right hip and groin area; range of motion is decreased. Hearing is mildly decreased on the right side. The remainder of the examination shows no abnormalities. Laboratory studies show:Hemoglobin 15 gdLSerumTotal protein 6.5 gdLBilirubin 0.8 mgdLAlanine aminotransferase 20 ULAlkaline phosphatase ALP 950 ULγ-Glutamyltransferase GGT 40 UL N550Calcium 9 mgdLPhosphate 4 mgdLParathyroid hormone450 pgmLAn x-ray of the hip shows cortical thickening and prominent trabecular markings. Which of the following is the most likely underlying mechanism of this patients symptoms?? A: Proliferation of plasma cells in the bone marrow, B: Increased rate of bone remodeling, C: Decreased bone mass with microarchitectural disruption, D: Infarction of the bone and marrow, E: Osteoblastic destruction of the bone,  <response>: Based on the information provided in the question stem, the key findings are:- 60-year-old man with progressive right hip and lower back pain over 4 weeks- Pain worse with exertion and at night - Recent history of heavy lifting and kneeling during home renovations- Localized tenderness over right hip and groin, decreased range of motion- Mildly decreased hearing on right side- Lab studies show elevated ALP and parathyroid hormone, other labs normal- X-ray shows cortical thickening and prominent trabecular markings in hipThis clinical presentation is most consistent with Pagets disease of bone. The elevated ALP and findings on x-ray support increased bone turnover. The elevated parathyroid hormone indicates a compensatory increase in response to increased bone remodeling. Pagets can affect a single bone or multiple bones, explaining the localized findings in the right hip.B: Increased rate of bone remodeling 