This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Intersex, Subject name: Gynaecology & Obstetrics
Lethargic, hypoglycemic female neonate with scrotum-like labia majora is suggestive of- 
Select and explain. 
A. Congenital adrenal hyperplasia, B. Turner's syndrome, C. Klinefelter's syndrome, D. Ovo-testicular disorder of sexual development
A: Congenital adrenal hyperplasia
Answer: A: Congenital adrenal hyperplasia 
Explanation: Above history point towards diagnosis of Congenital adrenal hyperplasia: - Due to deficiency of enzyme 21-Hydroxylase There is lack of coisol production resulting in excess of Adrenocoicotropic hormone (ACTH) production from pituitary. Features: - Enlarged clitoris Presence of penile urethra or hypospadias Associated metabolic abnormality -Salt wasting (hyponatremia, hyperkalemia) Fusion of Labia majora Lethargic hypoglycemic females. Investigations: - Karyotype is 46 XX Serum estimation Sex chromatin study reveals positive Barr body Sonographic evaluation