You are answering a USMLE-style medical question. Question: A 26-year-old woman presents to a gynecologist after a missed period. After performing a complete physical examination and a screening test for pregnancy, her gynecologist informs her that she is pregnant. She is very surprised as she has been taking oral contraceptives regularly. When the gynecologist asks her about the consumption of any other medications, she mentions that she was placed on treatment for pulmonary tuberculosis (TB) 2 months ago. Her current anti-TB regimen includes rifampin, isoniazid, pyrazinamide, and ethambutol. Which of the following mechanisms best explains the failure of oral contraceptives in this patient? Options: A) Induction of CYP3A4 by rifampin leading to decreased serum levels of ethinylestradiol and progesterone B) Induction of CYP2A6 by rifampin leading to increased inactivation of ethinylestradiol C) Interference with the intestinal absorption of the oral contraceptive by pyrazinamide D) Increased renal elimination of the progesterone component of the oral contraceptive by ethambutol Reply with ONLY the letter of the correct answer (A, B, C, or D). No explanation.

A
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