A 54-Year-Old Man Is Admitted to the Hospital Following a High-Speed

A 54-year-old man is admitted to the hospital following a high-speed motor vehicle accident.  He is found to have right leg long bone fractures requiring open reduction/internal fixation.  After the patient is stabilized, he is transferred to a skilled nursing facility for an extended rehabilitation period.  During his stay at the facility, his right leg is immobilized for several weeks.  The patient's management is complicated by decreased nutritional intake due to side effects from opioid pain medications.  Measurement of his thigh following removal of casting materials finds a 2-centimeter decrease in diameter during the time of immobilization.  This change in body measurement is due to a pathologic process similar to that seen in which of the following?

A) Adrenal glands during prolonged glucocorticoid therapy
B) Endometrial tissue during estrogen replacement therapy
C) Esophageal mucosa upon repeated acid exposure
D) Heart muscle during long-standing hypertension
E) Lung tissue after prolonged tobacco smoke exposure

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