<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 57-year-old woman returns to her primary care provider complaining of fever, skin rash, and flank pain. She had just visited her PCP 2 weeks ago complaining of a sore throat and was diagnosed with pharyngitis. She was then given a 10 day prescription for phenoxymethylpenicillin. Today she is on day 6 of her prescription. Her symptoms started yesterday. Past medical history is significant for type 2 diabetes mellitus, essential hypertension, and has gastroesophageal reflux disease. Her medications include metformin, captopril, hydrochlorothiazide, and pantoprazole and a multivitamin that she takes daily. Today her temperature is 38.0C 100.4F, the blood pressure is 14795 mm Hg, and the pulse is 82min. Physical examination shows a sparse maculopapular rash over her upper trunk. Laboratory results are shown:CBC with DiffLeukocyte count 9,500mm3Segmented neutrophils 54Bands 4Eosinophils 8Basophils 0.5Lymphocytes 30Monocytes 4Blood urea nitrogen 25 mgdLSerum creatinine 2 mgdLUrinalysis 27 white blood cells high powered field5 red blood cellshigh powered fieldUrine culture No growth after 72 hoursA urine cytospin with stained with Wrights stain shows 4.5 eosinophils. Which of the following is the best initial step in the management of this patient condition?? A: Short course of prednisolone, B: Discontinue the triggering medications, C: Renal biopsy, D: Supportive dialysis, E: Empiric oral fluoroquinolones,  <response>: This is a clinical case scenario involving a 57-year-old woman who recently developed fever, rash, and flank pain while taking phenoxymethylpenicillin for pharyngitis. She has a history of diabetes, hypertension, and GERD. The description of her symptoms, labs, and urinalysis are consistent with acute interstitial nephritis AIN. AIN is a type of kidney inflammation often caused by a reaction to medications like antibiotics. The presence of eosinophils in the urine supports this diagnosis. The best initial management would be to discontinue the triggering medication, phenoxymethylpenicillin, to prevent further kidney damage. Prednisolone may help reduce inflammation but would not address the underlying cause. Renal biopsy and dialysis are invasive and premature at this stage. Empiric antibiotics are unnecessary since she likely has AIN, not an infection.B: Discontinue the triggering medications 