<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 74-year-old man presents to the emergency department by paramedics for slurred speech and weakness in the left arm and leg for 1 hour. The patient was playing with his grandson when the symptoms started and his wife immediately called an ambulance. There is no history of head trauma or recent surgery. The patient takes captopril for hypertension. The vital signs include: pulse 110min, respiratory rate 22min, and blood pressure 200105 mm Hg. The physical examination shows that the patient is alert and conscious, but speech is impaired. Muscle strength is 05 in the left arm and leg and 55 in the right arm and leg. A non-contrast CT of the head shows no evidence of intracranial bleeding. The lab results are as follows:Serum glucose 90 mgdLSodium 140 mEqLPotassium 4.1 mEqLChloride 100 mEqLSerum creatinine 1.3 mgdLBlood urea nitrogen 20 mgdLCholesterol, total 240 mgdLHDL-cholesterol 38 mgdLLDL-cholesterol 100 mgdLTriglycerides 190 mgdLHemoglobin Hb 15.3 gdLMean corpuscular volume MCV 83 fLReticulocyte count 0.8Erythrocyte count 5.3 millionmm3Platelet count 130,000mm3Partial thromboplastin time aPTT 30 secProthrombin time PT 12 secAlthough he is within the time frame for the standard therapy of the most likely condition, the treatment cannot be started because of which of the following contraindications?? A: Creatinine level of 1.3 mgdL, B: A platelet count of 130,000mm3, C: Cholesterol level of 240 mgdL, D: Systolic blood pressure of 200 mm Hg, E: Age of 74 years,  <response>: This is a clinical case scenario describing a 74-year-old man who presents with sudden onset slurred speech and left-sided weakness. The description of the symptoms and physical exam findings are classic for an acute ischemic stroke. The question asks about a contraindication to the standard therapy for the most likely diagnosis. The most likely diagnosis based on the presentation is an ischemic stroke, for which the standard therapy is intravenous thrombolysis with tissue plasminogen activator tPA. The choices describe potential contraindications to giving tPA, which include:A Elevated creatinine - can increase bleeding risk B Low platelet count - increases bleeding riskC Elevated cholesterol - unrelated to tPA riskD Elevated blood pressure - requires control prior to tPAE Advanced age - relative contraindication but not absoluteTo identify the contraindication that would prevent giving tPA, we need to analyze the lab values and vitals signs provided.D: Systolic blood pressure of 200 mm Hg 