<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 33-year-old woman comes to the physician for the evaluation of bleeding from her gums for 2 weeks. These episodes occur spontaneously and are self-limiting. She has also had purplish skin lesions over her legs for 2 months. Last week, she had one episode of hematuria and watery diarrhea, both of which resolved without treatment. She has mild asthma. Her brother has hemophilia. Her only medication is a fenoterol inhaler. She appears healthy. Her temperature is 37.1C 99.3F, pulse is 88min, respirations are 14min, and blood pressure is 12274 mm Hg. Cardiopulmonary examination shows no abnormalities. The abdomen is soft and nontender; there is no organomegaly. Oropharyngeal examination shows gingival bleeding. There are petechiae over the neck and the right upper extremity and purpuric spots over both lower extremities. Laboratory studies show:Hemoglobin 13.3 mgdLMean corpuscular volume 94 μm3Leukocyte count 8,800mm3Platelet count 18,000mm3Bleeding time 9 minutesProthrombin time 14 seconds INR0.9Partial thromboplastin time 35 secondsSerumGlucose 88 mgdLCreatinine 0.9 mgdLWhich of the following is the most likely underlying mechanism of this patients symptoms?? A: Deficient Von Willebrand factor, B: Shiga-like toxin, C: Consumptive coagulopathy, D: IgG antibodies against platelets, E: Decrease in ADAMTS13 activity,  <response>: This is a question about a patient with symptoms of bleeding, including gingival bleeding, petechiae, purpura, and hematuria. She also has a low platelet count. The key finding is thrombocytopenia along with signs of bleeding, which indicates a disorder of platelet production or increased destructionconsumption of platelets. Based on the clinical history, the most likely diagnosis is immune thrombocytopenic purpura ITP. The patient has spontaneous bleeding episodes and purpura, which are classic for ITP. She also has a normal coagulation profile, ruling out coagulation disorders like hemophilia. The presence of hematuria and diarrhea makes infection with Shiga toxin-producing E. coli less likely. Von Willebrand disease is unlikely given her normal bleeding time. Therefore, the underlying mechanism is most likely destruction of platelets by IgG antibodies, leading to thrombocytopenia and bleeding episodes.D: IgG antibodies against platelets 