<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 19-year-old woman presents to her gynecologist for evaluation of amenorrhea and occasional dull right-sided lower abdominal pain that radiates to the rectum. She had menarche at 11 years of age and had regular 28-day cycles by 13 years of age. She developed menstrual cycle irregularity approximately 2 years ago and has not had a menses for 6 months. She is not sexually active. She does not take any medications. Her weight is 94 kg 207.2 lb and her height is 166 cm 5.4 ft. Her vital signs are within normal limits. The physical examination shows a normal hair growth pattern. No hair loss or acne are noted. There is black discoloration of the skin in the axillae and posterior neck. Palpation of the abdomen reveals slight tenderness in the right lower quadrant, but no masses are appreciated. The gynecologic examination reveals no abnormalities. The hymen is intact. The rectal examination reveals a non-tender, mobile, right-sided adnexal mass. Which of the following management plans would be best for this patient?? A: No imaging is indicated for this patient because the diagnosis can be made on the basis of the clinical examination, B: A transvaginal ultrasound would provide a better resolution of the suspected pathology, but a transabdominal ultrasound can still be used to assess this patient, C: Increased anterior abdominal wall adiposity does not pose any problems with a full urinary bladder, so a transabdominal ultrasound will provide the same sensitivity as a transvaginal ultrasound, D: Transabdominal ultrasound would be better for this patient because it can detect small pelvic masses better than a transvaginal ultrasound, E: Pelvic MRI is warranted in this case because transvaginal ultrasound cannot be performed and transabdominal ultrasound is unlikely to provide any diagnostic information,  <response>: This is a clinical case scenario about a 19-year-old woman presenting with amenorrhea, abdominal pain, and a pelvic mass. The key findings are:- Amenorrhea and irregular menses for 2 years- Dull right lower abdominal pain radiating to rectum- Non-sexually active - Obese BMI 34- Skin hyperpigmentation - Tenderness and palpable mass in right lower quadrant- Intact hymen- Mobile, non-tender right adnexal mass on rectal examThis presentation is most consistent with polycystic ovarian syndrome PCOS. The amenorrhea, obesity, skin changes, and pelvic mass all support this diagnosis. The question asks about the best imaging modality to further evaluate the pelvic mass. Transvaginal ultrasound provides the highest resolution for evaluating pelvic structures in non-virginal patients. However, this patient has an intact hymen, so transvaginal ultrasound is not an option. Of the remaining choices, transabdominal ultrasound is the best initial imaging test. It can adequately visualize pelvic structures despite the abdominal wall adiposity. MRI provides excellent pelvic imaging but is more costly and not necessarily needed as an initial study in this case.B: A transvaginal ultrasound would provide a better resolution of the suspected pathology, but a transabdominal ultrasound can still be used to assess this patient 