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Congenital adrenal hyperplasia (CAH) is associated with which of the following?

A
Male pseudohermaphroditism
B
Female pseudohermaphroditism
C
True hermaphroditism
D
Cushing syndrome
High-Yield Explanation
Ref. Guyton. 13th edition. Page. 781 Congenital Adrenal Hyperplasia Types 21 β-Hydroxylase deficiency Accounts for about 90% of the cases 
 75% of the cases have mineralocorticoid deficiency 
 Neonates may present with a salt-wasting crisis. 
 Salt wasters tend to have hyponatremia, hyperkalemia, and raised plasma renin. 
 17-hydroxyprogesterone is elevated. 
 Increased androgens lead to virilization of the female fetus and sexual ambiguity at birth 
 Males are phenotypically normal at birth but develop precocious pseu- do puberty, growth acceleration, premature epiphyseal plate closure, and diminished final height. 
 Goal in treatment is to bring glucocorticoid and mineralocorticoid back to the normal range which would also suppress adrenal androgen secretion. 
 Give hydrocortisone to act as feedback inhibition on pituitary 11 β-Hydroxylase deficiency 
 Clinical features of increased androgens similar to the preceding form, 
including virilization of female fetus. 
 The principal difference with this form is the hypertension produced by 11-deoxycorticosterone, along with hypokalemia and suppressed renin secretion. 
 Treatment for all forms of CAH is glucocorticoids such as hydrocortisone and dexamethasone. 
 17 α-Hydroxytlase deficiency 
 Extremely rare 
 Usually diagnosed at the time of puberty when the patient presents with hypertension, hypokalemia, and hypogonadism 
 Individuals have eunuchoid characteristics.

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