<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 23-year-old man comes to the emergency department with palpitations, sweating, and shortness of breath that began 10 minutes ago. He says, Please help me, I dont want to die. He has experienced several similar episodes over the past 2 months, which occurred without warning in situations including open spaces or crowds and resolved gradually after 5 to 10 minutes. He has been staying at home as much as possible out of fear of triggering another episode. He has no history of serious illness and takes no medications. He drinks 3 bottles of beer daily. He appears anxious and has a flushed face. His pulse is 104min, respirations are 12min, and blood pressure is 13582 mm Hg. Cardiopulmonary examination shows no abnormalities. An ECG shows sinus tachycardia. Which of the following is the most appropriate initial step in management?? A: Oral propranolol, B: Oral buspirone, C: Oral alprazolam, D: Oral venlafaxine, E: Long-term ECG monitoring,  <response>: This is a question about managing a 23-year-old man with recurrent episodes of palpitations, sweating, shortness of breath, and anxiety occurring in situations like open spaces or crowds. He has no significant medical history. On exam he appears anxious with sinus tachycardia but otherwise normal vital signs and unremarkable cardiopulmonary exam. The clinical presentation is most consistent with panic attacks. The episodes are triggered by specific situations, resolve spontaneously after several minutes, and are associated with anxiety and fear of having another episode. The treatment options listed include beta blockers propranolol, antianxiety medications buspirone, alprazolam, antidepressants venlafaxine, and long-term ECG monitoring. Since this is a case of panic attacks, medications for anxiety would be most appropriate. Alprazolam is a benzodiazepine with rapid onset that could help abort acute panic attacks. Buspirone is an antianxiety medication but has a slower onset. Propranolol, venlafaxine and long-term ECG monitoring are not indicated in this case.C: Oral alprazolam 