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: Pediatrics
Causes of female pseudohermaphroditism – 
Select and explain. 
A. 17–alpha hydroxylase deficiency, B. 21–alpha hydroxylase deficiency, C. Mixed gonadal dysgenesis, D. All of the above
B: 21–alpha hydroxylase deficiency
Answer: B: 21–alpha hydroxylase deficiency 
Explanation: Ambiguous genitalia (Hermaphroditism)

Ambiguous genitalia is defined as a discrepancy between the external genitals and internal gonads.
They can be categorized : -


Female pseudohermaphroditism
Male pseudohermaphroditism
True hermaphroditism

Female pseudohermaphroditism.

Genotype is XX
Gonads are ovaries
External genitalia is virilized (male differentiation).
As there is no Mullarian inhibiting factor, Mullerian duct develops into uterus tubes and ovary. But due to the presence of androgen external genitalia are virilized.

Causes are:

Maternal virilizing tumour → Arrhenoblastoma
21 hydroxylase deficiency
11 beta hydroxylase deficiency
Maternal medications with androgen