NBME Step 2 CK Form 8 21-Hydroxylase (NBME Answers)

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Retired NBME Answer Explanations

Retired NBME Step 2 CK Form 8 Answers

step2ck_form8/Block 3/Question#2 (reveal difficulty score)
A 22-year-old primigravid woman delivers a ...
21-Hydroxylase 🔍 / 📺 / 🌳 / 📖
tags: CAH endo

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XX newborn with ambiguous genitalia and elevated 17-hydroxyprogesterone levels, most consistent with 21-hydroxylase
Key idea: Three main enzymes that can be deficient in adrenal cortex pathway include (1) 21-hydroxylase (increased testosterone, decreased cortisol, decreased mineralocorticoids) (2) 11-hydroxylase (increased testosterone, decreased cortisol, normal/increased mineralocorticoids because 11-deoxycorticosterone has mineralocorticoid activity (3) 17-hydroxylase (decreased testosterone, decreased cortisol, increased mineralocorticoids)

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step_prep https://www.merckmanuals.com/professional/pediatrics/endocrine-disorders-in-children/congenital-adrenal-hyperplasia-caused-by-21-hydroxylase-deficiency +

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