<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A previously healthy 25-year-old woman is brought to the emergency department because of a 1-hour history of sudden severe lower abdominal pain. The pain started shortly after having sexual intercourse. The pain is worse with movement and urination. The patient had several urinary tract infections as a child. She is sexually active with her boyfriend and uses condoms inconsistently. She cannot remember when her last menstrual period was. She appears uncomfortable and pale. Her temperature is 37.5C 99.5F, pulse is 110min, and blood pressure is 9060 mm Hg. Abdominal examination shows a palpable, tender right adnexal mass. Her hemoglobin concentration is 10 gdL and her hematocrit is 30. A urine pregnancy test is negative. Pelvic ultrasound shows a 5 x 3-cm right ovarian sac-like structure with surrounding echogenic fluid around the structure and the uterus. Which of the following is the most appropriate management for this patients condition?? A: CT scan of the abdomen, B: Oral doxycycline and metronidazole administration, C: Uterine artery embolization, D: Intravenous methotrexate administration, E: Emergency exploratory laparotomy,  <response>: This is a question about the management of a 25-year-old woman with sudden onset of severe lower abdominal pain after sexual intercourse. The key findings are:- Acute onset of severe pain after intercourse - Worsening pain with movement and urination- History of UTIs as a child- Sexually active, inconsistent condom use- Tender adnexal mass on exam- Hemoglobin 10 gdL, hematocrit 30- Negative urine pregnancy test- Ultrasound showing 5x3 cm ovarian sac-like structure with surrounding fluidThis clinical presentation is most consistent with a ruptured ovarian cyst or ectopic pregnancy. The ultrasound findings of an adnexal mass with surrounding fluid indicate a ruptured ovarian cyst. An ectopic pregnancy cannot be completely ruled out given her sexual history and negative urine pregnancy test. Choice A of CT abdomen would provide additional imaging but is not the most appropriate next step. Choice B of antibiotic treatment with doxycycline and metronidazole may be indicated if pelvic inflammatory disease was the diagnosis, but this is less likely based on the clinical findings.Choice C of uterine artery embolization would not address the adnexal pathology. Choice D of methotrexate would be indicated for treating an ectopic pregnancy, but surgery is still required in a ruptured ectopic.Choice E of emergency exploratory laparotomy is the most appropriate next step to control bleeding and treat the ruptured ovarian cyst surgically.E: Emergency exploratory laparotomy 