<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 64-year-old woman otherwise healthy presents with acute onset severe rectal bleeding. The patient says that 2 hours ago bleeding began suddenly after a difficult bowel movement. She says the blood is bright red, and, initially, bleeding was brisk but now has stopped. The patient denies having any similar symptoms in the past. She has noticed that she bled more easily while having her regular manicurepedicure for the past 3 months but thought it was nothing serious. No significant past medical history and the patient does not take any current medications. Family history is unremarkable. Review of systems is positive for mild dyspnea on exertion the past 2-3 months. Her vital signs include: temperature 37.0C 98.6F, blood pressure 10065 mm Hg, pulse 95min, respiratory rate 15min, and oxygen saturation 97 on room air. A cardiac examination is significant for a 26 systolic murmur loudest at the right upper sternal border. Rectal exam shows no evidence of external hemorrhoids, fissures, or lesions. No active bleeding is noted. The stool is guaiac positive. Deficiency of which of the following is most likely the cause of this patients condition?? A: Vitamin K, B: Antithrombin III, C: von Willebrand factor, D: Factor VIII, E: ADAMST13 gene mutation,  <response>: This is a clinical vignette about a 64-year-old woman presenting with acute severe rectal bleeding after a difficult bowel movement. Key findings include:- Acute onset of bright red blood per rectum after straining during bowel movement, now resolved - No prior history of similar bleeding- Easy bruising for the past 3 months during manicurespedicures - Mild dyspnea on exertion for 2-3 months - New systolic heart murmur- Guaiac positive stoolThis presentation is most consistent with acquired von Willebrand disease due to aortic stenosis. The new heart murmur suggests possible aortic valve pathology leading to shear stress on von Willebrand factor multimers, causing their cleavage and dysfunction. This results in impaired platelet adhesion and a bleeding diathesis. Vitamin K deficiency, antithrombin III deficiency, and factor VIII deficiency would not present with such acute bleeding after trauma. ADAMST13 gene mutation causes thrombotic thrombocytopenic purpura, which also would not match this presentation.C: von Willebrand factor 