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NBME 17 Answers

nbme17/Block 2/Question#45 (9.6 difficulty score)
A 25-year-old woman comes to the physician ...
21-HydroxylaseπŸ”
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 +2 
submitted by icedcoffeeislyfe(35),

late onset CAH w/ 21 hydroxylase defiency--> excess androgens (increased facial hair and irregular menses, etc), salt wasting (low BP), increased 17-hydroxyprogesterone is key

11B problem= HTN and excess androgens 17a problem= HTN and decreased androgens 5a reductase converts testosterone to DHT 3B-hydroxysteroid dehydrogenase is involved in steroid synthesis earlier in the pathway

bingcentipede  If you see HYPOtension in a CAH question, it's gotta be 21-hydroxylase! +2  
bingcentipede  My special friend just gave me a mnemonic for this that I did not know. If the 1 is the 1st digit (11, 17) = hypertension. If there is a 1 in the 2nd digit (11, 21) = virilization. +1