This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Disorders of Adrenal Gland, Subject name: Medicine
Syndrome of apparent mineralocoicoid excess is due to? 
Select and explain. 
A. Increased aldosterone production, B. Lack of inactivation of aldosterone, C. Increased coisol production, D. Lack of Inactivation of coisol to coisone
D: Lack of Inactivation of coisol to coisone
Answer: D: Lack of Inactivation of coisol to coisone 
Explanation: Coisol can stimulate mineralocoicoid receptors. But renal inactivation of coisol occurs to form coisone and thereby BP remains normal. SAME (Syndrome of Apparent Mineralocoicoid Excess) leads to lack of this inactivation. The resultant increase in coisol leads to excess activation of mineralocoicoid receptor and results in hypeension.