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NBME 23 Answers

nbme23/Block 2/Question#36

A newborn has external genitalia that appear to be ...

Hyperplastic fetal adrenal glands

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46,XX DSD due to excessive and inappropriate exposure to androgenic steroids during early gestation (i.e. congenital adrenal hyperplasia).

jboud86  I'm just adding the page number from FA 2019 to this comment. FA 2019 page 625. +1  

Likely an inhibition of 21-hydroxylase. This is the most common of the congenital adrenal hyperplasias. Presents in infancy or childhood.

Another symptom they may have that I've seen around is vomiting!! Took me a while to find it, but they are salt wasting by having no aldosterone, so the loss of electrolytes is causing increased ICP.