<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 54-year-old man comes to the emergency department because of severe pain in his right leg that began suddenly 3 hours ago. He has had repeated cramping in his right calf while walking for the past 4 months, but it has never been this severe. He has type 2 diabetes mellitus, hypercholesterolemia, and hypertension. Current medications include insulin, enalapril, aspirin, and simvastatin. He has smoked one pack of cigarettes daily for 33 years. He does not drink alcohol. His pulse is 103min and blood pressure is 13684 mm Hg. Femoral pulses are palpable bilaterally. The popliteal and pedal pulses are absent on the right. Laboratory studies show:Hemoglobin 16.1 gdLSerumUrea nitrogen 14 mgdLGlucose 166 mgdLCreatinine 1.5 mgdLA CT angiogram of the right lower extremity is ordered. Which of the following is the most appropriate next step in management?? A: Remote ischemic preconditioning, B: Administer mannitol, C: Administer ionic contrast, D: Administer normal saline, E: Administer sodium bicarbonate,  <response>: This is a question about the management of acute limb ischemia in a patient with diabetes, hypercholesterolemia, hypertension and a history of smoking. The key findings are the sudden onset of severe right leg pain, absent popliteal and pedal pulses on the right, and a planned CT angiogram. The choices include various medicationsinterventions before the CT angiogram. The main goal before obtaining the CT angiogram is to maximize kidney perfusion and limit contrast-induced nephropathy, as the patient has multiple risk factors for kidney disease. Mannitol, normal saline, and sodium bicarbonate can all help maintain kidney perfusion and limit renal toxicity from the contrast. Remote ischemic preconditioning and ionic contrast provide no benefit in this situation.D: Administer normal saline 