<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 71-year-old woman presents to the clinic after an X-ray that revealed compression fractures of her L1 and L2 vertebral bodies due to osteoporotic changes. The patient has a history of hypertension for which she takes hydrochlorothiazide, and rheumatoid arthritis, for which she has been taking prednisone for the last 2 years. The patient states that she had a dual-energy X-ray absorptiometry DEXA scan 3 years ago that was normal and attributes that finding to regularly taking calcium and vitamin D supplements since then. The patient states that her pain from the fractures is stopping her from participating in her regular activities, such as exercising and gardening. Which of the following is the main cause of her osteoporosis?? A: Decreased estrogen levels, B: Hydrochlorothiazide HCTZ therapy, C: Calcium malabsorption, D: Bone depletion due to chronic corticosteroid use, E: Undiagnosed hyperparathyroidism,  <response>: This is a clinical vignette about a 71-year-old woman with compression fractures likely due to osteoporosis. The key parts of the history are:- 71-year-old woman, so postmenopausal and at risk for osteoporosis due to estrogen deficiency- Takes hydrochlorothiazide, which can cause bone loss - History of rheumatoid arthritis, on prednisone for 2 years. Chronic corticosteroid use is a major risk factor for osteoporosis.- Previously normal DEXA scan 3 years ago, which makes estrogen deficiency, calcium malabsorption, and hyperparathyroidism less likelyGiven the chronic high-dose corticosteroid use, choice D of bone depletion due to chronic corticosteroid use is most likely the main cause of her osteoporosis.D: Bone depletion due to chronic corticosteroid use 