<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 49-year-old woman comes to the physician because of a 1-year history of bloating and constipation alternating with diarrhea. She eats a balanced diet, and there are no associations between her symptoms and specific foods. She had been a competitive swimmer since high school but stopped going to training 4 months ago because her fingers hurt and turned blue as soon as she got into the cold water. She drinks one to two glasses of wine daily. Physical examination shows swollen hands and fingers with wax-like thickening of the skin. There are numerous small, superficial, dilated blood vessels at the tips of the fingers. The abdomen is distended and mildly tender with no guarding or rebound. Further evaluation is most likely to show which of the following findings?? A: Bilateral pupillary constriction, B: Outpouchings of the sigmoid colon, C: Villous atrophy in the duodenum, D: Periumbilical dilation of subcutaneous veins, E: Calcium deposits in the skin,  <response>: This is a clinical vignette describing a 49-year-old woman with a 1-year history of gastrointestinal symptoms and recent onset of finger discoloration and pain on exposure to cold. The key findings are bloating, constipationdiarrhea, swollen and discolored fingers, dilated blood vessels on the fingertips, abdominal distention and tenderness. The history of competitive swimming and recent intolerance to cold water exposure points towards a vascular issue affecting the fingers. The physical exam findings of swollen fingers, waxy thickening of the skin and dilated blood vessels on the fingertips are consistent with scleroderma. Scleroderma can affect the gastrointestinal system, causing motility issues. Calcium deposits in the skin are a common finding in scleroderma.Of the answer choices, calcium deposits in the skin choice E would be the most likely finding on further evaluation of this patient. The other findings are not consistent with the clinical presentation.E: Calcium deposits in the skin 