<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 4-year-old-female presents with a flattened, reddish 2 cm lump located at the base of the tongue. The patients mother reports her having trouble swallowing, often leading to feeding difficulties. The mother also reports lethargy, constipation, dry skin, and hypothermia. Which of the following is the most appropriate management of this patients presentation?? A: Combination therapy of methimazole and Beta-blockers, B: Week-long course of penicillin, C: Radioactive iodine ablation, D: Surgical excision of mass followed by levothyroxine administration, E: No treatment is necessary, counsel mother on alternative feeding techniques,  <response>: This question describes a 4-year-old girl with a lump at the base of her tongue along with symptoms of hypothyroidism like lethargy, constipation, dry skin, and hypothermia. The lump is likely a thyroid nodule or goiter causing compression symptoms like trouble swallowing. Hypothyroidism in a child this young suggests congenital hypothyroidism, often caused by thyroid dysgenesis. Surgical excision of the mass would relieve the compressive symptoms and allow for histological diagnosis. Levothyroxine administration would treat the underlying hypothyroidism. The other options listed do not appropriately address the patients presentation.D: Surgical excision of mass followed by levothyroxine administration 