<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 58-year-old man presents to the emergency department following a fall while walking in a grocery store. He has a history of at least 6 previous collapses to the ground with no warning. When these episodes occur, he becomes pale, diaphoretic, and recovers quickly within a few seconds. These episodes always occur when he is standing. His past medical history is significant for type 2 diabetes mellitus, hypercholesterolemia, and one myocardial infarction. His medication list includes aspirin, clopidogrel, bisoprolol, metformin, rosuvastatin, and valsartan. Further history reveals that he has constipation, early satiety, and recently lost 2.2 kg 5 lb of weight. While lying down, his blood pressure is 14564 mm Hg and the heart rate is 112min. After 2 minutes of standing, the blood pressure is 12065 mm Hg and the heart rate is 112min. A 12-lead ECG showed Q waves in leads II, III, and aVF. Laboratory results are given below:Hemoglobin 13.8 gdLWhite blood cell count 8500mm3Platelets 250,000mm3Sodium 142 mEqLPotassium 4.4 mEqLCalcium 9.1 mgdLCreatinine 1.0 mgdLTSH 1.4 UmLHbA1c 10.2What additional clinical feature would most likely be present in this patient?? A: Amyotrophy, B: Diplopia, C: Erectile dysfunction, D: Heat intolerance, E: Lipodystrophy,  <response>: This is a clinical vignette describing a 58-year-old man with a history of recurrent syncope when standing up. He has several comorbidities including diabetes, hypercholesterolemia, and previous myocardial infarction. The description of his episodes of syncope when standing suggests orthostatic hypotension. The lab results show no major electrolyte abnormalities. The question asks about an additional clinical feature that would likely be present.Based on the presentation, I would consider autonomic dysfunction as a potential cause of his orthostatic hypotension. Options like amyotrophy, diplopia, and heat intolerance do not fit with the presentation. Erectile dysfunction can be associated with autonomic dysfunction. Lipodystrophy can also occur in autonomic disorders like diabetes. However, erectile dysfunction seems most likely given his demographics and presentation.C: Erectile dysfunction 