<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 46-year-old man presents to the emergency department with confusion, lacrimation, salivation, nausea, vomiting, abdominal pain, and diarrhea. He developed these symptoms 30 minutes after he finished treating his garden with the insecticide malathion. His vital signs are as follows: blood pressure is 8550 mm Hg, heart rate is 49min, respiratory rate is 12min, and temperature is 36.5C 97.7F. At presentation, the patient is lethargic. Physical examination reveals pallor, mydriasis, nystagmus, widespread bilateral loud wheezes on lung auscultation, decreased heart sounds on cardiac auscultation, abdominal tenderness, and bilaterally increased upper and lower extremities muscle tone. Which of the following statements is true?? A: The patients symptoms are caused by reversible enzyme inhibition., B: Maximum reaction rate Vmax of the affected enzyme is not changed in this patient., C: The patients symptoms result from the formation of covalent bonds between malathion and the affected enzyme., D: The affected enzyme is inhibited by malathion via the formation of hydrogen bonds between its allosteric site and malathion phosphoric groups., E: Malathion activates the enzyme responsible for acetylcholine breakdown by modifying its allosteric site.,  <response>: This is a clinical vignette describing a patient who developed symptoms of cholinergic excess after exposure to the organophosphate insecticide malathion. The question is asking which statement about the mechanism of action of malathion toxicity is correct.The key points from the vignette are:- 46-year-old man with nausea, vomiting, diarrhea, confusion, lacrimation, salivation, abdominal pain, and muscle fasciculations after exposure to malathion - Vital signs show hypotension, bradycardia, decreased respiratory rate - Physical exam shows signs of cholinergic excess like miosis and muscle fasciculationsMalathion causes toxicity by irreversibly inhibiting acetylcholinesterase, the enzyme that breaks down acetylcholine. This results in excess acetylcholine accumulation and overstimulation of cholinergic receptors, causing the muscarinic and nicotinic symptoms described. Choices A and D describe reversible inhibition, which is incorrect for organophosphates like malathion that cause irreversible inhibition. Choice B is incorrect because irreversible inhibition decreases Vmax. Choice C is correct because malathion forms a covalent bond with acetylcholinesterase during irreversible inhibition. Choice E is incorrect because malathion inhibits rather than activates acetylcholinesterase.C: The patients symptoms result from the formation of covalent bonds between malathion and the affected enzyme. 