Congenital adrenal hyperplasia shows which clinical features-
**Core Concept**
Congenital adrenal hyperplasia (CAH) is a group of inherited disorders that affect the adrenal glands, leading to impaired cortisol and aldosterone production. This results from mutations in genes encoding enzymes involved in the steroidogenesis pathway, specifically 21-hydroxylase (CYP21A2), 11-beta-hydroxylase (CYP11B1), and 17-alpha-hydroxylase (CYP17A1).
**Why the Correct Answer is Right**
The impaired cortisol production in CAH leads to an increase in adrenocorticotropic hormone (ACTH) secretion, stimulating the adrenal glands to produce more androgens. This results in virilization of female infants, including clitoromegaly, hirsutism, and male-pattern baldness. Affected individuals may also exhibit salt-wasting due to inadequate aldosterone production, leading to hypotension, dehydration, and electrolyte imbalances.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incomplete.
**Option B:** This option is incomplete.
**Option C:** This option is incomplete.
**Clinical Pearl / High-Yield Fact**
A key clinical feature of CAH is the presence of hypokalemia (low potassium levels) due to the increased mineralocorticoid activity of 11-deoxycortisol, a precursor to cortisol.
**Correct Answer:** D. Virilization in female infants and salt-wasting due to inadequate aldosterone production.