This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Genetic Approach to Pediatric Medicine, Subject name: Pediatrics
[{'content': 'A female child presents with hypertension, hyperpigmentation and virilization, she is most likely to be suffering from deficiency of? \nSelect and explain. \nA. 11 beta hydroxylase deficiency, B. 21 alpha hydroxylase, C. 17 alpha hydroxylase, D. 3 beta hydroxylase', 'role': 'user'}, {'content': 'Answer: A \nExplanation: ANSWER: (A) 11 beta hydroxylase deficiencyREF: Nelson\'s 18th ed p. 2366See APPENDIX-58 below for details of "Congenital adrenal hyperplasia" APPENDIX - 58Congenital Adrenal HyperplasiaCAH is very frequently asked in pre PG examinations with different case scenarios. There is a simple way to remember the symptomatology and reach to the conclusion of the deficient enzyme.Enzyme deficientAldosteroneTestosterone11 (if 1 is to increase, 11 is to both testosterone and aldosterone increases)| (salt retention, hypertension)|Precocious puberty in malesAmbiguous genitalia in females17 (1 is to increase so only aldosterone increases)| (salt retention, hypertension)|Ambiguous genitalia in malesPrecocious puberty in females21 & 3 (1 is to increase so only testosterone increases)| (salt wasting, hypotension)|Precocious puberty in malesAmbiguous genitalia in femalesLipoid| (salt wasting, hypotension)|Ambiguous genitalia in malesPrecocious puberty in femalesSymptoms as per the increase or decrease of aldosterone and testosterone will be:f Aldosterone = salt retention & hypertension (irrespective of the gender)I Aldosterone = salt wasting & hypotension (irrespective of gender)t Testosterone = Ambiguous genitalia in females, precocious puberty in malesI Testosterone = Ambiguous genitalia in males, precocious puberty in females', 'role': 'assistant'}]