<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 35-year-old man comes to the physician because of progressive swelling of his legs over the past 2 months. During this period, the patient has had an unintentional 5-kg 11-lb weight gain. He also reports frequent numbness of the tips of his fingers and cramping in his back and leg muscles. He has a history of HIV infection treated with combined antiretroviral therapy. The patient immigrated to the US from Nigeria 3 years ago. His temperature is 37C 98.6F, pulse is 80min, and blood pressure 15090 mm Hg. Physical examination shows 3 periorbital and lower extremity edema bilaterally. Sensation to pinprick and light touch is decreased around the mouth and along the fingers. Laboratory studies show:SerumAlbumin 2.5 gdLTotal cholesterol 270 mgdLHIV antibody positiveUrineBlood negativeProtein 4RBC 1-2hpfRBC casts negativeA kidney biopsy is most likely to show which of the following findings under light microscopy?? A: Thickened glomerular capillary loops, B: Segmental sclerosis, C: Crescent formation, monocytes, and macrophages, D: Mesangial proliferation, E: No changes,  <response>: This is a clinical vignette describing a 35-year-old man with HIV infection who has developed peripheral edema, numbness in his fingers, muscle cramps, elevated blood pressure, and proteinuria. The key findings are HIV infection, peripheral edema, hypoalbuminemia, hypercholesterolemia, proteinuria with minimal hematuria, and normal urine sediment. The clinical presentation and laboratory findings are most consistent with nephrotic syndrome in the setting of HIV-associated nephropathy HIVAN. HIVAN classically presents with heavy proteinuria and renal insufficiency. On kidney biopsy, the pathognomonic finding is focal segmental glomerulosclerosis. Choice A describes thickening of the glomerular basement membrane, which would not be expected in HIVAN. Choice B describes segmental sclerosis, which is the classic pathological finding in HIVAN. This is likely to be the correct answer.Choice C describes a crescentic glomerulonephritis, which would not be expected in HIVAN. The urine sediment does not suggest an active glomerular inflammation.Choice D describes mesangial proliferation, which can be seen in HIVAN but is not the classic pathological finding.Choice E describes normal kidney histology, which would not explain the patients clinical presentation and laboratory abnormalities.B: Segmental sclerosis 