<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 40-year-old male with Down syndrome is brought to your clinic by his mother. She reports that over the past few months he has started having difficulty managing his daily routine at his assisted-living facility and no longer seems like himself. She says that last week he wandered away from the facility and was brought back by police. Additionally, he has stopped taking his regular antiepileptic medication, and she is concerned that he might have a seizure. TSH is checked and is normal. Which of the following is most likely to be responsible for this mans current presentation?? A: Expansion of trinucleotide repeats, B: Abnormal protein metabolism, C: Hormone deficiency, D: Premature degradation of a protein, E: Nutritional deficiency,  <response>: This is a clinical vignette about a 40-year-old male with Down syndrome who is exhibiting behavioral changes such as difficulty managing daily routines, wandering away from home, and stopping medication. The question asks what is most likely responsible for his presentation. The choices include expansion of trinucleotide repeats, abnormal protein metabolism, hormone deficiency, premature degradation of a protein, and nutritional deficiency. Down syndrome is caused by an extra copy of chromosome 21, which can lead to abnormal protein metabolism and premature degradation of proteins. This makes choices B and D reasonable options. Hormone deficiency and nutritional deficiency are less likely in Down syndrome. Expansion of trinucleotide repeats does not play a role in Down syndrome.B: Abnormal protein metabolism 