<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 31-year-old obese Caucasian female presents to the Emergency Department late in the evening for left lower quadrant pain that has progressively worsened over the last several hours. She describes the pain as sharp and shooting, coming and going. Her last bowel movement was this morning. She has also had dysuria and urgency. Her surgical history is notable for gastric bypass surgery 2 years prior and an appendectomy at age 9. She is sexually active with her boyfriend and uses condoms. Her temperature is 99.5 deg F 37.5 deg C, blood pressure is 15183 mmHg, pulse is 86min, respirations are 14minute, BMI 32. On physical exam, she has left lower quadrant tenderness to palpation with pain radiating to the left groin and left flank tenderness on palpation. Her urinalysis shows 324 red blood cellshigh power field. Her pregnancy test is negative. What is the next best step in management?? A: A KUB kidneys, ureters and bladder plain film, B: Intravenous pyelogram, C: Transvaginal ultrasound, D: Noncontrast CT scan, E: Exploratory laparoscopy,  <response>: This is a question about a 31-year-old obese woman presenting with left lower quadrant abdominal pain that has worsened over several hours. Key findings in the stem include left lower quadrant tenderness that radiates to the left groin, left flank tenderness, dysuria, hematuria, and a surgical history notable for appendectomy and gastric bypass surgery. The differential diagnosis includes diverticulitis, ovarian torsion, ectopic pregnancy, urinary tract infection, nephrolithiasis, and bowel obstruction. Imaging is needed to distinguish between these potential diagnoses. A KUB x-ray would not provide enough detail. An IV pyelogram exposes the patient to unnecessary contrast and radiation. A transvaginal ultrasound may be helpful for ruling out ovarian torsion or ectopic pregnancy but does not evaluate the colon or kidneys. A noncontrast CT scan of the abdomen and pelvis can evaluate all the organs of concern and is the best next step. Exploratory laparoscopy is too invasive as the initial test.D: Noncontrast CT scan 