<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 59-year-old man with a history of congestive heart failure presents to his cardiologist for a follow-up visit. His past medical history is notable for diabetes mellitus, hypertension, and obesity. He takes metformin, glyburide, aspirin, lisinopril, and metoprolol. He has a 40 pack-year smoking history and drinks alcohol socially. His temperature is 99.1F 37.2C, blood pressure is 15065 mmHg, pulse is 75min, and respirations are 20min. Physical examination reveals bilateral rales at the lung bases and 1 edema in the bilateral legs. The physician decides to start the patient on an additional diuretic but warns the patient about an increased risk of breast enlargement. Which of the following is the most immediate physiologic effect of the medication in question?? A: Decreased bicarbonate reabsorption in the proximal convoluted tubule, B: Decreased sodium reabsorption in the thick ascending limb, C: Decreased sodium reabsorption in the distal convoluted tubule, D: Decreased sodium reabsorption in the collecting duct, E: Decreased renin enzyme activity,  <response>: This is a multiple choice question asking about the most immediate physiologic effect of a diuretic medication that can cause breast enlargement in men. Based on the information provided, the patient likely has congestive heart failure and the physician is adding a diuretic medication to help reduce fluid overload. The side effect of breast enlargement indicates the medication is likely a potassium-sparing diuretic like spironolactone. Potassium-sparing diuretics work by blocking aldosterone receptors in the collecting ducts of the kidneys, preventing sodium reabsorption at that site. Therefore, the most immediate effect of the medication would be decreased sodium reabsorption in the collecting duct.D: Decreased sodium reabsorption in the collecting duct 