<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 27-year-old man comes to the physician because of worsening abdominal pain over the last several months. He has also had recent feelings of sadness and a lack of motivation at work, where he is employed as a computer programmer. He denies suicidal thoughts. He has a history of multiple kidney stones. He has a family history of thyroid cancer in his father and uncle, who both underwent thyroidectomy before age 30. His temperature is 37C 98F, blood pressure is 13886 mm Hg, and pulse is 87min. Physical examination shows diffuse tenderness over the abdomen and obesity but is otherwise unremarkable. Serum studies show:Na 141 mEqLK 3.6 mEqLGlucose 144 mgdLCa2 12.1 mgdLAlbumin 4.1 gdLPTH 226 pgmL normal range 1288 pgmLResults of a RET gene test return abnormal. The physician refers him to an endocrine surgeon. Which of the following is the most appropriate next step in diagnosis?? A: Thyroidectomy, B: Urine metanephrines, C: Urine 5-HIAA, D: Midnight salivary cortisol, E: Serum gastrin,  <response>: This is a clinical vignette describing a 27-year-old man with worsening abdominal pain, recent depressive symptoms, obesity, family history of early-onset thyroid cancer, and lab results showing elevated PTH. The key findings are the family history of early-onset thyroid cancer, abnormal RET gene test, and elevated PTH, which point towards a diagnosis of multiple endocrine neoplasia type 2 MEN2. MEN2 is an autosomal dominant syndrome caused by RET mutations, leading to medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism. The next step would be to evaluate for pheochromocytoma prior to thyroidectomy, since undiagnosed pheochromocytoma poses risks during surgery. B: Urine metanephrines 