<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 21-year-old primigravid woman comes to the physician at 10 weeks gestation because of progressive fatigue for the past 3 weeks. She reports that she has had a 3.2-kg 7-lb weight loss after conceiving despite an increase in appetite. She has become increasingly anxious and has trouble falling asleep. There is no personal or family history of serious illness. Medications include folic acid and a multivitamin. She is 165 cm 5 ft 5 in tall and weighs 55 kg 120 lb; BMI is 20 kgm2. Her temperature is 37.4C 99.4F, pulse is 120min, respirations are 18min, and blood pressure is 15070 mm Hg. The globes of the eyes are prominent. The thyroid gland is firm and diffusely enlarged. Neurologic examination shows a fine resting tremor of the hands. There is a midsystolic click at the apex and a grade 26 early systolic murmur at the upper left sternal border. Serum thyroid-stimulating hormone concentration is 0.1 μUmL. An ECG is normal except for sinus tachycardia. Which of the following is the most appropriate next step in management?? A: Lugols iodine, B: Thyroidectomy, C: Propylthiouracil, D: Radioactive iodine ablation, E: Atenolol,  <response>: This is a question about managing a patient with hyperthyroidism in pregnancy. The key findings are a 21-year-old pregnant woman with weight loss, anxiety, tremor, tachycardia, thyroid enlargement, and low TSH consistent with hyperthyroidism. The choices include antithyroid medications propylthiouracil, surgery thyroidectomy, radioactive iodine, beta blockers atenolol, and iodine Lugols solution. In pregnancy, the main priority is treating the mothers hyperthyroidism while avoiding harm to the fetus. Radioactive iodine is contraindicated in pregnancy due to risk of fetal hypothyroidism. Thyroidectomy has risks of anesthesia and surgery. Beta blockers treat symptoms but not the underlying disease. Lugols iodine is not used for long-term treatment. Propylthiouracil is the safest antithyroid medication in pregnancy and the most appropriate choice to treat the hyperthyroidism.C: Propylthiouracil 