<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 48-year-old woman with a history of obesity presents with acute onset of diffuse epigastric pain that began a few hours ago and then localized to the right upper quadrant. Further questioning reveals that the pain has been exacerbated by eating but has otherwise been unchanged in nature. Physical exam reveals severe right upper quadrant pain that is accompanied by arrest of respiration with deep palpation of the right upper quadrant. Which of the following symptoms is associated with the most likely etiology of this patients presentation?? A: Hematemesis, B: Pain with passive right leg raising, C: Crunching sound upon heart auscultation, D: Diffuse substernal pain, E: Pain radiating to the right shoulder,  <response>: This is a clinical vignette describing a 48-year-old obese woman with acute onset of epigastric pain that started diffusely and then localized to the right upper quadrant. The pain is exacerbated by eating. On exam she has severe RUQ pain and positive Murphys sign. The key findings here are the acute onset of pain that started epigastrically and localized to the RUQ, exacerbation with eating, and positive Murphys sign on exam. This clinical presentation is most consistent with acute cholecystitis inflammationinfection of the gallbladder. Of the answer choices, choice E Pain radiating to the right shoulder is most consistent with acute cholecystitis. This refers to radiation of the gallbladder pain to the right shoulder or scapula, which is a classic symptom of acute cholecystitis. The other answer choices do not fit with the clinical vignette.E: Pain radiating to the right shoulder 