<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 18-year-old male presents to his primary care provider with his parents for a sports physical. He was last seen in clinic several months ago, when he was diagnosed with attention deficit hyperactivity disorder ADHD. He was started on methylphenidate at that time, and the patient now reports improvement in his ability to concentrate in school and at home. He hopes to play baseball in college and has begun lifting weights daily in preparation for baseball season. The patient reports that he eats a healthy diet to fuel his exercise regimen. His parents have no concerns and are pleased with the recent improvement in his grades. On physical exam, the patient has tall stature with average muscle mass for his age. He has no dysmorphic features. His chest has a normal appearance other than mild gynecomastia. The patient has sparse facial hair and a moderate amount of coarse pubic hair that extends across the pubis and spares the medial thighs. His testes are small and firm. Due to the latter, laboratory testing is performed and reveals the following:Follicle-stimulating hormone FSH: 42 mIUmL Reference range: 4-25 mIUmLLuteinizing hormone LH: 38 mIUmL Reference range: 6-23 mIUmLWhich of the following is the most likely etiology of this patients presentation?? A: Anabolic steroid use, B: CGG trinucleotide repeat disorder, C: CTG trinucleotide repeat disorder, D: Failure of neuronal migration, E: Meiotic nondisjunction,  <response>: This is a clinical vignette describing an 18-year-old male with a history of ADHD who is being evaluated for a sports physical. On exam, he is noted to have tall stature, mild gynecomastia, sparse facial hair, small testes, and elevated FSH and LH levels. The key findings are the small, firm testes and elevated gonadotropins FSH and LH, which indicate primary hypogonadism or testicular failure. This is causing incomplete virilization and delayed puberty. The differential diagnosis includes:A Anabolic steroid use - This can suppress gonadotropins and testosterone production. However, steroids would not cause small, firm testes.B CGG trinucleotide repeat disorder - This refers to fragile X syndrome, which does not present with hypogonadism. C CTG trinucleotide repeat disorder - This refers to myotonic dystrophy, which does not present with hypogonadism.D Failure of neuronal migration - This refers to conditions like Kallmann syndrome that can cause hypogonadotropic hypogonadism. However, gonadotropins would be low, not elevated. E Meiotic nondisjunction - This refers to Klinefelter syndrome 47,XXY, which is the most likely diagnosis given the patients tall stature, hypogonadism, sparse body hair, and elevated gonadotropins.E: Meiotic nondisjunction 