[Verified Answer]: A 58-year-old woman comes to the clinic to…

A 58-year-old woman comes to the clinic to establish care. On review of systems, the patient says she is concerned because she has had worsening weakness over the past six weeks and now I can barely walk without assistance of a walker. She also has had unintentional weight gain of 20 pounds during this time that has caused purple stretch marks on her abdomen. She has not had urinary symptoms or constipation. Medical history includes rheumatoid arthritis. Current medications include prednisone 20 mg daily. The patient says she has been taking 40 mg daily for the past six months because of the severity of her pain. Blood pressure is 178/103. Other vital signs are within normal limits. Physical examination shows a fat pad on the posterior aspect of the neck, central obesity, and abdominal stride. Muscle wasting and decreased strength of the lower extremities are noted. Examination of the hand show swan neck deformity is consistent with severe rheumatoid arthritis. Which of the following is the most likely cause of this patient ambulatory dysfunction? A Cushing syndrome B hyper para thyroidism C osteoporosis, D primary adrenal insufficiency or E vitamin D deficiency?