<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 13-year-old girl presents to her pediatrician with vaginal bleeding and abdominal pain. The patient states that this has happened sporadically over the past 4 months. She is currently experiencing these symptoms and has soaked through 1 pad today. She denies being sexually active or using any illicit substances. Her vitals are within normal limits, and physical exam is notable for a healthy young girl with a non-focal abdominal and pelvic exam. Which of the following is the best next step in management?? A: Administer azithromycin and ceftriaxone, B: Order a coagulation profile, C: Perform a CT scan of the abdomen, D: Perform hysteroscopy and biopsy, E: Reassurance and discharge,  <response>: This is a case of a 13-year-old girl with intermittent vaginal bleeding and abdominal pain over the past 4 months. She is currently having symptoms but is otherwise healthy on exam. The key findings are vaginal bleeding in an adolescent girl along with abdominal pain. The differential diagnosis includes conditions like pregnancy, infection, ovarian cysts, endometriosis etc. However, given the intermittent nature of her symptoms over several months and lack of concerning findings on history and physical exam, the most likely diagnosis is anovulatory cycles which are common during adolescence when periods are often irregular.Choice A for azithromycin and ceftriaxone would be used to treat pelvic inflammatory disease, but there is no evidence to suggest PID based on the information provided. Choice B to order coagulation testing may be reasonable if heavy menstrual bleeding was suspected, but the description of bleeding does not indicate excessive blood loss.Choice C for CT abdomen could identify anatomical causes but has risks from radiation exposure and would not be warranted based on the history provided.Choice D for hysteroscopy and biopsy would be overly aggressive as a first step.Choice E for reassurance and discharge is most appropriate next step given likely diagnosis of anovulatory bleeding. Reassurance about the common nature of irregular cycles during adolescence is reasonable. Follow up can be arranged unless symptoms persist or worsen.E: Reassurance and discharge 