<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 42-year-old man comes to the emergency department complaining of chest pain. He states that he was at the grocery store when he developed severe, burning chest pain along with palpitations and nausea. He screamed for someone to call an ambulance. He says this has happened before, including at least 4 episodes in the past month that were all in different locations including once at home. He is worried that it could happen at work and affect his employment status. He has no significant past medical history, and reports that he does not like taking medications. He has had trouble in the past with compliance due to side effects. The patients temperature is 98.9F 37.2C, blood pressure is 13374 mmHg, pulse is 110min, and respirations are 20min with an oxygen saturation of 99 on room air. On physical examination, the patient is tremulous and diaphoretic. He continually asks to be put on oxygen and something for his pain. An electrocardiogram is obtained that shows tachycardia. Initial troponin level is negative. A urine drug screen is negative. Thyroid stimulating hormone and free T4 levels are normal. Which of the following is first line therapy for the patient for long-term management?? A: Alprazolam, B: Buspirone, C: Cognitive behavioral therapy, D: Fluoxetine, E: Imipramine,  <response>: This is a question about choosing the appropriate long-term management for a 42-year-old man with recurrent episodes of chest pain, palpitations, and nausea. Based on the information provided, this sounds most consistent with panic disorder. The key findings are recurrent unexpected panic attacks in different locations, absence of underlying cardiac or other medical cause, and excessive worry about having another attack. The answer choices list different medication options as well as cognitive behavioral therapy CBT. Since the patient has had issues with medication compliance and side effects in the past, and CBT is first-line for panic disorder, CBT is likely the best initial long-term management. Alprazolam, buspirone, fluoxetine, and imipramine are all medications that could be used but would not be preferred over CBT given the clinical scenario.C: Cognitive behavioral therapy 