A 15 kg child has a urine output of 360 mL during the past 12 hours. Calculate the child’s urine output in mL/kg/hour for this period of time. (Do not enter units).

The correct answer is a) Androgens.

Choice A reason:

Congenital adrenal hyperplasia (CAH) is a group of genetic disorders affecting the adrenal glands, which are responsible for producing vital hormones such as cortisol, aldosterone, and androgens. In CAH, there is a deficiency of the enzyme 21-hydroxylase, which is crucial for the synthesis of cortisol and aldosterone. As a result, the adrenal glands overproduce androgens, leading to symptoms such as ambiguous genitalia in newborns, early puberty, and rapid growth. Androgens are male sex hormones, including testosterone, which play a significant role in the development of male characteristics.

Choice B reason:

Vitamin K is a fat-soluble vitamin essential for blood clotting and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin K deficiency can lead to bleeding disorders, but it does not cause the symptoms associated with CAH, such as ambiguous genitalia or early puberty. Therefore, this choice is incorrect.

Choice C reason:

Gonadotropins are hormones produced by the pituitary gland that stimulate the gonads (ovaries and testes) to produce sex hormones and gametes (eggs and sperm). While gonadotropins play a role in sexual development and reproduction, they are not overproduced in congenital adrenal hyperplasia. The primary issue in CAH is the overproduction of androgens due to enzyme deficiencies in the adrenal glands. Therefore, this choice is incorrect.

Choice D reason:

Vitamin D is a fat-soluble vitamin essential for calcium absorption and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin D deficiency can lead to bone disorders such as rickets in children and osteomalacia in adults, but it does not cause the symptoms associated with CAH. Therefore, this choice is incorrect.

Choice A reason:

Rye and oats: Rye contains gluten, which must be avoided by individuals with celiac disease. Oats, while naturally gluten-free, can often be contaminated with gluten during processing. Therefore, they should be introduced cautiously and only if labeled gluten-free.

Choice B Reason:

Wheat and corn: Wheat is a major source of gluten and must be strictly avoided by those with celiac disease. Corn, on the other hand, is naturally gluten-free and safe for consumption. However, since wheat is included in this option, it is not suitable for a gluten-free diet.

Choice C Reason:

Rice and soy: Both rice and soy are naturally gluten-free and safe for individuals with celiac disease. They are excellent alternatives to gluten-containing grains and provide essential nutrients.

Choice D Reason:

Barley and millet grain: Barley contains gluten and must be avoided by those with celiac disease. Millet is naturally gluten-free and safe for consumption. However, since barley is included in this option, it is not suitable for a gluten-free diet.