<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 40-year-old woman comes to the emergency department due to severe right flank pain, fever, chills, and decreased urine output. The vital signs include a temperature of 39.0C 102.2F, heart rate of 120min, a regular breathing pattern, and blood pressure of 12870 mm Hg. Cardiopulmonary auscultation is normal. In addition, tenderness is elicited by right lumbar percussion. After initiating intravenous antibiotics empirically, the condition of the patient improves significantly. However, a low urine output persists. The results of the ordered laboratory tests are as follows:Urine culture Proteus mirabilis, 150,000 CFUmL normal range: 100,000 CFUmL to no bacterial growth in asymptomatic patientsDensity 1.030; Leukocyte esterase ; Nitrites pH 7.8 normal range: 4.58.0C-reactive protein 60 mgdL normal range: 010 mgdLSerum creatinine 1.8 mgdL normal range: 0.61.2 mgdLBUN 40 mgdL normal range: 720 mgdLPlain abdominal film Complex renal calculus in the right kidneyWhich of the following is the most likely type of stone the patient has?? A: Xanthine, B: Uric acid, C: Cystine, D: Struvite, E: Calcium oxalate,  <response>: Based on the information provided in the question stem, this patient is a 40-year-old woman presenting with symptoms and signs consistent with a kidney stone, including severe flank pain, fever, chills, decreased urine output, tenderness on percussion over the kidney, and laboratory findings of leukocytosis, elevated CRP, renal insufficiency, and pyuria. The urine culture growing 100,000 CFUmL Proteus mirabilis suggests this is likely an infection-related kidney stone. The alkaline urine pH of 7.8 also supports an infection-related stone. Of the answer choices provided, struvite stones also known as infection stones are the most commonly associated with Proteus urinary tract infections. Struvite stones form in alkaline urine in the presence of urease-producing bacteria like Proteus that split urea into ammonia and increase urine pH.Therefore, based on the clinical presentation and urine culture results, the most likely type of kidney stone in this patient is a struvite stone.D: Struvite 