<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 44-year-old woman comes to the emergency department after waking up with facial swelling and with difficulties speaking and swallowing. She states that she does not have allergies or recently had insect bites. She has a 4-year history of hypertension and type 2 diabetes mellitus controlled with medication. Her pulse is 110min, respirations are 20min, and blood pressure is 14090 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 97. On physical exam, she appears uncomfortable, with notable swelling of the lips and tongue. The remainder of the examination shows no abnormalities. Serum C4 levels are within normal limits. Which of the following is the most likely underlying mechanism of this patients symptoms?? A: Type 2 hypersensitivity reaction, B: IgE-mediated histamine release, C: Anaphylactoid reaction, D: Immune-complex deposition, E: Impaired bradykinin metabolism,  <response>: This is a clinical vignette describing a patient with acute angioedema without urticaria or known allergies. The key findings are acute swelling of the lips and tongue, normal C4 levels, and a history of hypertension and diabetes. The differential diagnosis includes:- Type I IgE-mediated allergic reaction unlikely given lack of urticaria and no known allergies- Type II cytotoxic reaction no evidence to support this- Type III immune complex reaction normal C4 makes this less likely - Hereditary angioedema normal C4 makes this unlikely- Acquired angioedema due to C1 esterase inhibitor deficiency normal C4 makes this less likely- Anaphylactoid reaction - ACE inhibitor-induced angioedema history of hypertension makes this a possibilitySo this patient most likely has ACE inhibitor-induced angioedema due to impaired bradykinin metabolism.E: Impaired bradykinin metabolism 