<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 32-year-old woman presents to the office with complaints of intense anal pain every time she has a bowel movement. The pain has been present for the past 4 weeks, and it is dull and throbbing in nature. It is associated with mild bright red bleeding from the rectum that is aggravated during defection. She has no relevant past medical history. When asked about her sexual history, she reports practicing anal intercourse. The vital signs include heart rate 98min, respiratory rate 16min, temperature 37.6C 99.7F, and blood pressure 11066 mm Hg. On physical examination, the anal sphincter tone is markedly increased, and its impossible to introduce the finger due to severe pain. What is the most likely diagnosis?? A: Anorectal abscess, B: Deterioration of the connective tissue that anchors hemorrhoids, C: Rectal prolapse and paradoxical contraction of the puborectalis muscle, D: Local anal trauma, E: Inflammatory bowel disease,  <response>: This is a clinical case question involving a 32-year-old woman with complaints of intense anal pain during bowel movements over the past 4 weeks. The key findings in the stem are:- Intense, dull, throbbing anal pain during bowel movements - Mild bright red rectal bleeding aggravated during defecation- History of anal intercourse- Increased anal sphincter tone on exam, severe pain on digital rectal examBased on the acute onset of symptoms in the setting of a history of anal intercourse, the main diagnostic consideration is local anal trauma. Choice A can be ruled out as anorectal abscesses present with swelling and purulent drainage. Choice B relates to hemorrhoids which are not supported. Choice C describes rectal prolapse which is not mentioned. Choice E for inflammatory bowel disease is unlikely in the acute setting without chronicity. D: Local anal trauma 