This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
[{'content': 'Which of the following statement about congenital adrenal hyperplasia is not true - \nSelect and explain. \nA. 21-alpha hydroxylase deficiency is the most common cause, B. Males present with precocious puberty, C. Females present with ambiguous genitalia, D. Hypokalemic alkalosis is seen', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Deficiency of 21α hydroxylase is the most common cause of congenital adrenal hyperplasia.\nDue to the deficiency of this enzyme there is no synthesis of mineralocorticoid and glucocorticoids in the adrenal cortex.\nDecreased mineralocorticoid causes marked sodium loss in the urine resulting in hyponatremia, hyperkalemia acidosis and hypotension.\nDue to deficiency of 21α hydroxylase there is increased formation of 17 hydroxyprogesterone which is then shunted into the production of testosterone.\nThis causes virilisation in females and precocious puberty in males.', 'role': 'assistant'}]