<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 24-year-old woman presents to the emergency department with severe abdominal and lower back pain. She describes it as intense cramping and states that she experienced severe pain roughly 1 month ago that was similar. The patients past medical history is non-contributory, and she states that her menses cause her to soak through 1 pad in a day. She is currently sexually active and does not use any contraception. Her vitals are within normal limits. The patients abdominal exam is non-focal, and her pelvic exam reveals no adnexal masses or tenderness and no cervical motion tenderness. Which of the following is the most likely diagnosis?? A: Adenomyosis, B: Appendicitis, C: Ectopic pregnancy, D: Leiomyoma, E: Primary dysmenorrhea,  <response>: This is a clinical case of a 24-year-old woman presenting with severe abdominal and lower back pain. The key findings are:- Severe cramping pain occurring about 1 month apart, suggesting a cyclical pattern- Heavy menstrual bleeding, soaking 1 pad per day- Sexually active without contraception- Normal vitals and abdominal exam, no adnexal masses or cervical motion tenderness on pelvic examThe cyclical nature of the pain along with heavy periods and no significant exam findings make me lean towards a diagnosis of primary dysmenorrhea. Ectopic pregnancy is a consideration given she is sexually active without contraception, but I would expect more localized abdominal pain and abnormal pelvic exam findings. The lack of fever and localized abdominal tenderness make appendicitis less likely. Adenomyosis and leiomyomas may cause heavy menstrual bleeding but not the degree of cramping pain described.E: Primary dysmenorrhea 