<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 35-year-old woman with type 1 diabetes mellitus comes to the emergency department for evaluation of a 1-month history of fever, fatigue, loss of appetite, and a 3.6-kg 8-lb weight loss. She has also had a cough for the last 2 months. She reports recent loss of pubic hair. The patient immigrated from the Philippines 7 weeks ago. Her mother has systemic lupus erythematosus. She has never smoked and does not drink alcohol. Her only medication is insulin, but she sometimes misses doses. She is 165 cm 5 ft 5 in tall and weighs 49 kg 108 lb; BMI is 18 kgm2. She appears lethargic. Her temperature is 38.9C 102F, pulse is 58min, and blood pressure is 9060 mm Hg. Examination shows decreased sensation to touch and vibration over both feet. The remainder of the examination shows no abnormalities. Serum studies show:Na 122 mEqLCl- 100 mEqLK 5.8 mEqLGlucose 172 mgdLAlbumin 2.8 gdLCortisol 2.5 μgdLACTH 531.2 pgmL N527 pgmLCT scan of the abdomen with contrast shows bilateral adrenal enlargement. Which of the following is the most likely underlying mechanism of this patients symptoms?? A: Adrenal infarction, B: Adrenal hemorrhage, C: Pituitary tumor, D: Infection with acid-fast bacilli, E: Autoimmune adrenalitis,  <response>: This is a clinical case scenario describing a 35-year-old woman with type 1 diabetes presenting with fever, fatigue, weight loss, cough, and recent immigration from the Philippines. Key findings include low sodium, low chloride, high potassium, low albumin, low cortisol, high ACTH, adrenal enlargement on CT, and loss of pubic hair. The differential diagnosis includes adrenal insufficiency due to infection, hemorrhage, infarction, or an autoimmune process. The history of recent immigration from the Philippines and bilateral adrenal enlargement on CT make infection with tuberculosis the most likely diagnosis. Elevated ACTH and low cortisol indicate secondary adrenal insufficiency due to destruction of the adrenal glands from tuberculosis infection.D: Infection with acid-fast bacilli 