<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:An 80-year-old male with known metastatic prostate cancer presents to your office with vague complaints of achy bones. Strangely, he refers to you using the name of another physician. On physical exam, he is afebrile, but mildly tachycardic at 100 beatsmin. Mucous membranes are dry. Cardiac exam shows regular rhythm and no murmurs. The patient has diffuse, nonfocal abdominal pain. He cannot articulate the correct date. You check the patients serum calcium level, which is found to be 15.3 mgdL. What is the best next step in management?? A: Pamidronate, B: Intravenous normal saline, C: Calcitonin, D: Furosemide, E: Hemodialysis,  <response>: This is a clinical vignette describing an elderly male with known metastatic prostate cancer who presents with symptoms concerning for hypercalcemia, including confusion, abdominal pain, and elevated serum calcium. The key findings are the patients cancer diagnosis, mental status changes, abdominal pain, and markedly elevated calcium level of 15.3 mgdL normal range is 8.5-10.5 mgdL. Hypercalcemia is a common paraneoplastic complication of cancer that can cause mental status changes, abdominal pain, cardiac arrhythmias, and kidney injury if left untreated. The immediate goal is to lower the severely elevated calcium level. Pamidronate is a bisphosphonate drug that inhibits osteoclast-mediated bone resorption, which is the main cause of hypercalcemia in metastatic bone disease. It is the treatment of choice for hypercalcemia of malignancy. Intravenous fluids help promote calcium excretion but are not sufficient as monotherapy. Calcitonin provides rapid but short-lived reduction in calcium levels. Furosemide is not first-line for hypercalcemia and may worsen intravascular volume depletion. Hemodialysis is reserved for refractory, life-threatening hypercalcemia unresponsive to medical management.B: Intravenous normal saline 