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Medicine Disorders of Adrenal Gland 99588874

All of the following investigations are needed for evaluation of the given case except?

A
X ray wrist and elbow
B
Karyotype
C
Serum electrolytes
D
24 hour urinary chloride
High-Yield Explanation
The image shows clitoromegaly, labial fusion of a virilised female child. Inguinal folds don't exhibit any mass or swelling. The leading cause for this is congenital adrenal hyperplasia. Deficiency of 21-hydroxylase, resulting from mutations or deletions of CYP21A, is the most common form of CAH, accounting for more than 90% of cases. Choice A Useful for determining bone age which is advanced in CAH due to sex steroids Choice B Useful to identify CAH where a girl child has ambiguous genitalia Choice C Useful due to salt wasting and elevated potassium secondary to decreased aldosterone levels 24 hour urinary chloride is useful for renal tubular disorders like Bater syndrome and Gitelman syndrome.

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