A 3500-g (7.7-lbs) female newborn is delivered at 39 weeks' gestation to a 27-year-old woman, gravida 2, para 1. Apgar scores are 8 and 9 at 1 and 5 minutes, respectively. The mother had regular prenatal visits throughout the pregnancy. She did not smoke or drink alcohol. She took multivitamins as prescribed by her physician. The newborn appears active. Her temperature is 37.0°C (98.6°F) , pulse is 120/min, and blood pressure is 55/35 mm Hg. Examination in the delivery room shows clitoromegaly. Laboratory results are as follows: Which of the following additional laboratory findings are most likely to be seen in this patient?

Question

A 3500-g (7.7-lbs) female newborn is delivered at 39 weeks' gestation to a 27-year-old woman, gravida 2, para 1. Apgar scores are 8 and 9 at 1 and 5 minutes, respectively. The mother had regular prenatal visits throughout the pregnancy. She did not smoke or drink alcohol. She took multivitamins as prescribed by her physician. The newborn appears active. Her temperature is 37.0°C (98.6°F) , pulse is 120/min, and blood pressure is 55/35 mm Hg. Examination in the delivery room shows clitoromegaly. Laboratory results are as follows:

Which of the following additional laboratory findings are most likely to be seen in this patient?

Quizplus · Accepted Answer

Eductional Objective: Classic 21-hydroxylase deficiency causes decreased cortisol and aldosterone production with increased adrenal androgen production.  In boys, this deficiency presents 1-2 weeks after birth with vomiting, hypotension, hyponatremia, and hyperkalemia due to salt wasting; genitalia are normal.  In girls, it presents at birth with ambiguous genitalia.

A 3500-G (7