<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 20-year-old woman visits the clinic for her annual physical examination. She does not have any complaints during this visit. The past medical history is insignificant. She follows a healthy lifestyle with a balanced diet and moderate exercise schedule. She does not smoke or drink alcohol. She does not take any medications currently. The family history is significant for her grandfather and uncle who had their parathyroid glands removed. The vital signs include: blood pressure:12288 mm Hg, pulse 88min, respirations 17min, and temperature 36.7C 98.0F. The physical exam is within normal limits. The lab test results are as follows:Blood Urea Nitrogen 12 mgdLSerum Creatinine 1.1 mgdLSerum Glucose Random 88 mgdLSerum chloride 107 mmolLSerum potassium 4.5 mEqLSerum sodium 140 mEqLSerum calcium 14.5 mmolLSerum albumin 4.4 gmdLParathyroid Hormone PTH 70 pgmL Normal: 10-65 pgmL24-Hr urinary calcium 85 mgday Normal: 100300 mgdayWhich of the following is the next best step in the management of this patient?? A: Parathyroidectomy, B: Start IV fluids to keep her hydrated, C: No treatment is necessary, D: Start her on pamidronate, E: Give glucocorticoids,  <response>: This is a question about hyperparathyroidism in a 20-year-old woman. Based on the information provided, the patient has an elevated PTH level of 70 pgmL normal 10-65 pgmL along with a normal serum calcium level and a low 24-hour urinary calcium excretion. She has a family history of parathyroid gland removal in her grandfather and uncle. The next best step would be to confirm the diagnosis of primary hyperparathyroidism with repeat testing of PTH and calcium levels. Surgery parathyroidectomy would be an option if she has persistentworsening hypercalcemia and hyperparathyroidism. The other answer choices are not indicated at this point. IV fluids, pamidronate and glucocorticoids would not be appropriate initial management. No treatment is also not correct, as she likely has early primary hyperparathyroidism that needs to be monitored and managed.C: No treatment is necessary 