<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:Four days after undergoing a Whipple procedure for newly-diagnosed pancreatic cancer, a 65-year-old man has shortness of breath. His surgery was complicated by bleeding for which he required intraoperative transfusion with 4 units of packed red blood cells and 1 unit of platelets. His temperature is 38.8C 101.8F, pulse is 110min, respirations are 26min, and blood pressure is 9555 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 85. Cardiac examination shows normal heart sounds and no jugular venous distention. Auscultation of the lungs shows diffuse crackles bilaterally. The extremities are warm and there is no edema. Laboratory studies show a leukocyte count of 17,000mm3 and hemoglobin concentration of 9.8 gdL. Arterial blood gas on room air shows:pH 7.35PaO2 41 mm HgPaCO2 38 mm HgHCO3- 25 mEqLThe patient is intubated and mechanical ventilation is initiated. An x-ray of the chest is shown. Transthoracic echocardiography shows a normally contracting left ventricle. Which of the following is the most likely cause of this patients current condition?? A: Acute occlusion of a pulmonary artery, B: Decreased chest wall compliance, C: Formation of anti-leukocyte antibodies, D: Diffuse inflammatory alveolar damage, E: Increased left atrial pressures,  <response>: This is a clinical vignette describing a 65-year-old man who underwent a Whipple procedure for pancreatic cancer 4 days ago. The surgery was complicated by bleeding and he required blood transfusions. He now presents with shortness of breath, fever, tachycardia, tachypnea, hypoxemia, and diffuse pulmonary crackles on exam. Chest X-ray shows diffuse bilateral infiltrates. The key findings are: - Recent major surgery - Bleedingtransfusions during surgery- Fever - Tachycardia, tachypnea - Hypoxemia- Diffuse pulmonary crackles - Chest X-ray with diffuse bilateral infiltratesThis presentation is most consistent with acute respiratory distress syndrome ARDS. The timeline fits with early ARDS given the recent surgery. The bleeding and transfusions likely resulted in systemic inflammation that precipitated diffuse alveolar damage leading to ARDS. The hypoxemia and bilateral infiltrates are characteristic of ARDS. The other choices can be ruled out:- Pulmonary embolism would not cause bilateral diffuse infiltrates- Decreased chest wall compliance would not cause hypoxemia - Antibody reaction is less likely in this acute timeframe - Increased left atrial pressures would cause pulmonary edema but not diffuse alveolar damage.D: Diffuse inflammatory alveolar damage 