Anatomy

A 15-day-old male neonate presented with failure to thrive, recurrent vomiting and symptoms of shock. On examination, severe dehydration is noted. He has normal genitalia along with precocious development of pubic hair, phallic enlargement and accelerated skeletal maturation. BP of the child was normal. Lab findings revealed hyponatremia and hypokalemia, increased serum 17 -hydroxyprogesterone and increased urinary pregnanetriol. A biopsy from the adrenal gland was taken. Which of the following is the most likely enzyme deficiency in the above patient: -