<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 23-year-old gravida-1-para-1 G1P1 presents to the emergency department with fever, malaise, nausea, and abdominal pain. She says her symptoms started 2 days ago with a fever and nausea, which have progressively worsened. 2 hours ago, she started having severe lower abdominal pain that is diffusely localized. Her past medical history is unremarkable. Her last menstrual period was 3 weeks ago. She has had 3 sexual partners in the past month and uses oral contraception. The vital signs include temperature 38.8C 102.0F and blood pressure 12075 mm Hg. On physical examination, the lower abdomen is severely tender to palpation with guarding. Uterine and adnexal tenderness is also elicited. A urine pregnancy test is negative. On speculum examination, the cervix is inflamed with positive cervical motion tenderness and the presence of a scant yellow-white purulent discharge. Which of the following is the most likely diagnosis in this patient?? A: Vaginitis, B: Cervicitis, C: Pelvic inflammatory disease, D: Ruptured ectopic pregnancy, E: Urinary tract infection,  <response>: This is a clinical vignette describing a 23-year-old woman with fever, malaise, nausea, and abdominal pain that started 2 days ago and has progressively worsened. Key findings on history include recent sexual activity with multiple partners, use of oral contraceptives, and last menstrual period 3 weeks ago. On exam she has abdominal tenderness and guarding, uterineadnexal tenderness, inflamed cervix with discharge, and cervical motion tenderness. The acute onset of symptoms in a sexually active woman along with pelvic exam findings of cervical motion tenderness and uterineadnexal tenderness point towards pelvic inflammatory disease as the most likely diagnosis. Cervicitis could cause cervical inflammation but would not explain the more systemic symptoms or uterineadnexal tenderness. Vaginitis and UTI would not cause these pelvic exam findings. An ectopic pregnancy is unlikely given the negative pregnancy test.C: Pelvic inflammatory disease 