**Core Concept**
Congenital adrenal hyperplasia (CAH) is a group of inherited disorders that affect the adrenal glands, leading to impaired production of cortisol and aldosterone, and excessive production of androgens. This condition is characterized by mutations in genes encoding enzymes involved in the synthesis of cortisol and aldosterone from cholesterol.

**Why the Correct Answer is Right**
The most common form of CAH is due to 21-hydroxylase deficiency, which leads to a deficiency in cortisol and aldosterone production. This results in an overproduction of androgens, causing virilization in female patients. The metabolic abnormalities associated with CAH include hypokalemia, hypertension, and metabolic acidosis due to the lack of aldosterone, as well as hyperkalemia and hyponatremia due to the loss of potassium and sodium in the urine.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is likely incorrect because it is a common metabolic abnormality seen with CAH.
**Option B:** This option is also incorrect because it is a characteristic feature of CAH.
**Option C:** This option is incorrect because it is not a typical metabolic abnormality associated with CAH.

**Clinical Pearl / High-Yield Fact**
In CAH, the excess production of androgens can lead to virilization of female patients, including clitoral enlargement and male pattern baldness. This is a key clinical feature that can aid in the diagnosis of CAH.

**Correct Answer: D.**