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Retired NBME 22 Answers

nbme22/Block 1/Question#12 (reveal difficulty score)
During the first week of life, a male newborn ...
21-Hydroxylase ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: CAH endo

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submitted by โˆ—wutuwantbruv(52)
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Can't be 17ฮฑ-hydroxylase because this would present with hypertension and some sort of ambiguous sexual presentation (males) or lack of secondary sexual development (females). Can't be 11ฮฒ-hydroxylase because this would present with the opposite of the kid's presentation due to the production of 11-deoxycorticosterone (similar effects to aldosterone but not nearly as potent). The other two would not really make sense since there are increased levels of 17-hydroxyprogesterone

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submitted by โˆ—dr.xx(176)
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Congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

https://en.wikipedia.org/wiki/Congenital_adrenal_hyperplasia_due_to_21-hydroxylase_deficiency

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wutuwantbruv  Can't be 17ฮฑ-hydroxylase because this would present with hypertension and some sort of ambiguous sexual presentation (males) or lack of secondary sexual development (females). Can't be 11ฮฒ-hydroxylase because this would present with the opposite of the kid's presentation due to the production of 11-deoxycorticosterone (similar effects to aldosterone but not nearly as potent). The other two would not really make sense since there are increased levels of 17-hydroxyprogesterone. +1



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submitted by โˆ—tekkenman101(19)
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The moment you see hyponatremia, dehydration, and SALT WASTING in an infant, child, or neonate then stop reading the rest of the question and automatically pick 21-hydroxylase deficiency. That should save you like a minute.

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skonys  Also elevated 17-hydroxyprogesterone. They'll almost definitely mention that. +1



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