<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 57-year-old woman undergoes an operation for a long-term toxic multinodular goiter. 13 hours after the procedure, she complains of tingling around her lips and difficulty breathing. While measuring her blood pressure, her hand turned as seen in the picture. On physical examination, she looks anxious and her chest is wheezy on both sides. Which of the following is the best initial treatment of this patient?? A: Oral calcium and calcitriol, B: Human recombinant parathyroid hormone PTH, C: Oral magnesium, D: Intravenous calcium gluconate, E: Thiazide diuretic,  <response>: This is a clinical vignette describing a patient who recently underwent thyroid surgery and is now experiencing perioral tingling, difficulty breathing, and carpopedal spasm, which indicates hypocalcemia. The question is asking for the best initial treatment.Based on the symptoms of hypocalcemia following thyroid surgery, the likely diagnosis is postoperative hypoparathyroidism leading to hypocalcemia. The best initial treatment would be intravenous calcium to immediately raise the serum calcium level and resolve the acute hypocalcemic symptoms.Oral calcium and calcitriol would take too long to raise the calcium level in this acute situation. PTH and thiazide diuretics are not appropriate treatments for acute hypocalcemia. Magnesium may be used as an adjunctive treatment but would not be sufficient as monotherapy for the acute hypocalcemia.D: Intravenous calcium gluconate 