<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 16-year-old female presents to your clinic concerned that she has not had her menstrual cycle in 5 months. She has not been sexually active and her urine pregnancy test is negative. She states that she has been extremely stressed as she is in the middle of her gymnastics season and trying to get recruited for a college scholarship. Physical exam is remarkable for a BMI of 16, dorsal hand calluses, and fine hair over her cheeks. What other finding is likely in this patient?? A: Polycythemia, B: Elevated TSH, C: Normal menstrual cycles, D: Elevated estrogen levels, E: Low bone density,  <response>: This is a question about secondary amenorrhea in an adolescent female. The key details in the stem are that she has not had a menstrual period in 5 months, she is not pregnant, she is very stressed due to gymnastics, and she has physical exam findings of low BMI, calluses, facial hair, and thin hair, which are suggestive of an eating disorder and hormonal abnormalities. The choices given are laboratory and physical exam findings. Polycythemia choice A and elevated TSH choice B are not likely in this case. Normal menstrual cycles choice C contradict the information provided. Elevated estrogen levels choice D are also not expected in a patient with amenorrhea. Low bone density choice E can occur with amenorrhea due to estrogen deficiency and is often seen in patients with eating disorders, so this is the most likely finding.E: Low bone density 