Your 21-Year-Old Female Patient Presents with a History of Secondary

Your 21-year-old female patient presents with a history of secondary amenorrhea, acne, hyperpigmentation, clitoral enlargement, and physical and mental fatigue. Her blood pressure is 160/105 mmHg and laboratory values indicate hypokalemia, low fasting blood glucose, and hypernatremia. What, in the light of these findings, is the most likely cause of her symptoms?

A) An adrenocorticotropic hormone (ACTH) -secreting tumor
B) 11β-hydroxylase deficiency
C) Absence of androgen receptors
D) 21-hydroxylase deficiency
E) Primary hypercortisolism