<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 78-year-old man presents to the emergency department because of confusion that started 2 hours ago. The patients daughter says that he has had blurred vision for several days. His right leg became weak 10 days ago, and he couldnt walk for a few days before recovering. He was diagnosed with monoclonal gammopathy of undetermined significance 2 years ago. His temperature is 36.2C 97.2F, pulse is 75min, respirations are 13min, and blood pressure is 12570 mm Hg. He also has gingival bleeding. Cervical lymphadenopathy is palpated on physical exam. Both the liver and spleen are palpated 5 cm below the costal margins. The serum protein electrophoresis with immunofixation is shown. Urine electrophoresis shows no abnormalities. A skeletal survey shows no abnormalities. Which of the following best explains these findings?? A: Chronic lymphocytic leukemia, B: Diffuse large B-cell lymphoma, C: Monoclonal gammopathy of undetermined significance, D: Multiple myeloma, E: Waldenstroms macroglobulinemia,  <response>: This is a clinical vignette describing a 78-year-old man with confusion, blurred vision, leg weakness, monoclonal gammopathy of undetermined significance, lymphadenopathy, hepatosplenomegaly, abnormal serum protein electrophoresis with immunofixation, and normal urine electrophoresis and skeletal survey. The key findings are:- Monoclonal gammopathy of undetermined significance 2 years ago - Confusion, blurred vision, leg weakness - suggests neurologic involvement- Lymphadenopathy and hepatosplenomegaly - suggests lymphoproliferative disorder- Abnormal serum protein electrophoresis with monoclonal spike - suggests plasma cell dyscrasia- Normal urine electrophoresis and skeletal survey - makes multiple myeloma less likelyBased on the monoclonal gammopathy, neurologic symptoms, organomegaly, and abnormal serum protein electrophoresis, the most likely diagnosis is Waldenstroms macroglobulinemia.E: Waldenstroms macroglobulinemia 