<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 46-year-old man is brought to the emergency department because of severe epigastric pain and vomiting for the past 4 hours. The pain is constant, radiates to his back, and is worse on lying down. He has had 34 episodes of greenish-colored vomit. He was treated for H. pylori infection around 2 months ago with triple-regimen therapy. He has atrial fibrillation and hypertension. He owns a distillery on the outskirts of a town. The patient drinks 45 alcoholic beverages daily. Current medications include dabigatran and metoprolol. He appears uncomfortable. His temperature is 37.8C 100F, pulse is 102min, and blood pressure is 13886 mm Hg. Examination shows severe epigastric tenderness to palpation with guarding but no rebound. Bowel sounds are hypoactive. Rectal examination shows no abnormalities. Laboratory studies show:Hematocrit 53Leukocyte count 11,300mm3SerumNa 133 mEqLCl- 98 mEqLK 3.1 mEqLCalcium 7.8 mgdLUrea nitrogen 43 mgdLGlucose 271 mgdLCreatinine 2.0 mgdLTotal bilirubin 0.7 mgdLAlkaline phosphatase 61 ULAST 19 ULALT 17 ULγ-glutamyl transferase GGT 88 uL N550 ULLipase 900 UL N14280 ULWhich of the following is the most appropriate next step in management?? A: Calcium gluconate therapy, B: Fomepizole therapy, C: Laparotomy, D: Endoscopic retrograde cholangio-pancreatography, E: Crystalloid fluid infusionn,  <response>: This is a patient with severe epigastric pain, vomiting, and elevated lipase. Based on the clinical presentation and lab findings, this patient likely has acute pancreatitis. The most appropriate next step would be management of acute pancreatitis, which involves fluid resuscitation, pain control, monitoring for complications, and identifying the cause.Choice A calcium gluconate therapy would be used for hypocalcemia, which is not a feature in this case. Choice B fomepizole would be used for ethylene glycol or methanol toxicity, which is not suspected here. Choice C laparotomy is too aggressive as a next step. This would only be considered if complications like pancreatic necrosis or abscess occur.Choice D ERCP may help identify gallstone pancreatitis but is not the immediate next step. This is an invasive procedure that carries risks.Choice E crystalloid fluid infusion is the most appropriate next step to help resolve the intravascular volume depletion and prevent further complications in acute pancreatitis.E: Crystalloid fluid infusion 