<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 33-year-old Caucasian female presents to her primary care provider for pruritus and shortness of breath. Over the past year, she has experienced mild progressive diffuse pruritus. She also reports that her skin seems hard and that it has been harder to move her fingers freely. She initially attributed her symptoms to stress at work as a commercial pilot, but when her symptoms began impacting her ability to fly, she decided to seek treatment. She has a history of major depressive disorder and takes citalopram. She smokes 1 pack per day and drinks socially. Her temperature is 98.6F 37C, blood pressure is 14888 mmHg, pulse is 83min, and respirations are 21min. On exam, she appears anxious with increased work of breathing. Dry rales are heard at her lung bases bilaterally. Her fingers appear shiny and do not have wrinkles on the skin folds. A normal S1 and S2 are heard on cardiac auscultation. This patients condition is most strongly associated with which of the following antibodies?? A: Anti-cyclic citrullinated peptide, B: Anti-DNA topoisomerase I, C: Anti-double-stranded DNA, D: Anti-SS-A, E: Anti-U1-ribonucleoprotein,  <response>: Based on the description in the question stem, the key findings in this patient are:- 33-year-old Caucasian female - Pruritus and shortness of breath- Skin hardening and decreased mobility of fingers- Dry rales in lungs bilaterally- Fingers appear shiny without skin wrinklesThis presentation is most consistent with systemic sclerosis scleroderma, an autoimmune disease characterized by fibrosis of the skin and internal organs. The shiny fingers without wrinkles point to tightening and thickening of the skin. Lung involvement with dry rales indicates pulmonary fibrosis. Systemic sclerosis is most strongly associated with anti-DNA topoisomerase I antibodies previously called anti-Scl-70 antibodies. These antibodies are present in around 30 of systemic sclerosis patients.The other antibody choices are not specifically associated with systemic sclerosis. Anti-CCP is associated with rheumatoid arthritis, anti-dsDNA with lupus, anti-SS-A with Sjogrens syndrome, and anti-U1 RNP with mixed connective tissue disease.B: Anti-DNA topoisomerase I 