You are answering a USMLE-style medical question. Question: A 21-year-old woman comes to the physician for evaluation of excess hair growth on her face. Menses occur irregularly at 45 to 65-day intervals. She is 159 cm (5 ft 3 in) tall and weighs 59 kg (130 lb); BMI is 23 kg/m2. Physical examination shows facial acne and growth of coarse dark hair on the face, chest, and lower back. Pelvic examination shows no abnormalities. Serum studies show: Sodium 141 mEq/L Potassium 4.2 mEq/L Glucose 109 mg/dL Cortisol (1600 h) 4 μg/dL Prolactin 14 ng/mL 17-hydroxyprogesterone 390 ng/dL (N=20–300 ng/dL) Testosterone 91 ng/dL (N=8–60 ng/dL) A urine pregnancy test is negative. This patient's condition is most likely associated with which of the following?" Options: A) Hyperproliferation of theca interna cells B) Exogenous anabolic steroid use C) Ovarian fibrosis and multiple cystic follicles D) Hyperplasia of the adrenal cortex Reply with ONLY the letter of the correct answer (A, B, C, or D). No explanation.