<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 42-year-old woman presents to her primary care provider with vision loss. She reports that twice over the last 2 weeks she has had sudden black out of the vision in her right eye. She notes that both episodes were painless and self-resolved over approximately a minute. The patients past medical history is significant for hypertension, diet-controlled diabetes mellitus, and hypothyroidism. Her family history is notable for coronary artery disease in the patients father and multiple sclerosis in her mother. Ophthalmologic and neurologic exam is unremarkable. Which of the following is the best next step in management?? A: Check serum inflammatory markers, B: Emergent referral to ophthalmology, C: Intravenous dexamethasone, D: MRI of the brain, E: Ultrasound of the carotid arteries,  <response>: This is a patient with transient monocular vision loss, which raises suspicion for transient ischemic attack TIA involving the retinal artery. The most important next step is to evaluate for carotid artery stenosis, which can be a source of retinal artery emboli causing TIA. Inflammatory markers would not be useful, as there are no symptoms to suggest inflammatory disease. Emergent ophthalmology referral is not required since the episodes resolved. IV steroids would not be appropriate initial management. MRI of the brain may be reasonable but carotid ultrasound is more specific for evaluating the likely source.E: Ultrasound of the carotid arteries 