<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 31-year-old African American woman presents to her primary care provider complaining of stiff, painful fingers. She reports that her symptoms started 2 years ago and have gradually worsened. Her pain is not relieved by ibuprofen or acetaminophen. She is most concerned about having occasional episodes in which her fingers become extremely painful and turn white then pale blue. Her past medical history is notable for hypertension but she has previously refused to take any medication. She works as a postal worker and spends most of her time outside. Physical examination reveals induration of her digits with loss of skin fold wrinkles. She has limited finger range of motion. She would like to know if she can do anything to address her intermittent finger pain as it is affecting her ability to work outside in the cold. Which of the following medications is most appropriate to address this patients concerns?? A: Ambrisentan, B: Diltiazem, C: Enalapril, D: Methotrexate, E: Nifedipine,  <response>: This appears to be a question about treating a patient with Raynauds phenomenon and possible underlying connective tissue disease. The description of painful, stiff fingers that turn white and blue is classic for Raynauds. The patient also has physical exam findings consistent with connective tissue disease such as scleroderma, including induration and loss of skin fold wrinkles. Raynauds phenomenon can be primary or secondary to an underlying condition like scleroderma. Treatment focuses on managing symptoms and preventing progression. Calcium channel blockers like nifedipine are first-line to improve blood flow and decrease vasospasm episodes. Methotrexate may be used for severe Raynauds or as a DMARD for underlying inflammatory arthritis or connective tissue disease. ACE inhibitors treat hypertension but have not been shown to help Raynauds. Ambrisentan is an endothelin receptor antagonist used in pulmonary hypertension. Diltiazem is a calcium channel blocker but not first-line for Raynauds.E: Nifedipine 