<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 53-year-old female presents with worsening shortness of breath with activity. Physical exam reveals a diastolic murmur with an opening snap. The patients medical history is significant for a left hip replacement 10 years ago, and she vaguely recalls an extended period of illness as a child described as several severe episodes of sore throat followed by rash, fever, and joint pains. Administration of which of the following treatments at that time would have been most effective in reducing her risk of developing cardiac disease?? A: Acyclovir, B: Penicillin, C: Vancomycin, D: Aspirin, E: Ciprofloxacin,  <response>: This is a patient with symptoms of mitral stenosis, likely due to rheumatic heart disease given her history of streptococcal pharyngitis sore throat as a child. The most effective treatment to prevent rheumatic heart disease is early antibiotic treatment of streptococcal pharyngitis with penicillin. Acyclovir treats herpes viruses, not streptococcus. Vancomycin is not first-line for strep pharyngitis. Aspirin and ciprofloxacin do not treat strep pharyngitis. Therefore, the correct answer is penicillin.B: Penicillin 