<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 78-year-old female presents to her primary care provider complaining of shaking of her hands. She reports that her hands shake when she is pouring her coffee in the morning and when she is buttoning her shirt. She has noticed that her tremor improves with the several beers she has every night with dinner. She has a past medical history of hypertension, atrial fibrillation, moderate persistent asthma, acute intermittent porphyria, and urinary retention. Her home medications include hydrochlorothiazide, warfarin, bethanechol, low-dose inhaled fluticasone, and an albuterol inhaler as needed. On physical exam, she has an irregularly irregular heart rhythm without S3S4. She has mild wheezing on pulmonary exam. She has no tremor when her hands are in her lap. A low-amplitude tremor is present during finger-to-nose testing. Her neurological exam is otherwise unremarkable.Which of the following is a contraindication to the first-line treatment of this condition?? A: Acute intermittent porphyria, B: Asthma, C: Heavy alcohol use, D: Urinary retention, E: Warfarin use,  <response>: This is a clinical vignette about a 78-year-old female with a tremor that improves after drinking alcohol. The key findings are an action tremor that is present on finger-to-nose testing and improves after drinking alcohol. This suggests a diagnosis of essential tremor. The question asks about contraindications to first-line treatment. First-line treatment of essential tremor is with a beta-blocker like propranolol. Contraindications include asthma, acute intermittent porphyria, and possibly urinary retention. Warfarin use is not an absolute contraindication but requires close monitoring. Heavy alcohol use is not a contraindication.B: Asthma 