A 21-Year-Old Woman Comes to the Physician for Evaluation of Excess

A 21-year-old woman comes to the physician for evaluation of excess hair growth on her face. Menses occur irregularly at 45 to 65-day intervals. She is 159 cm (5 ft 3 in) tall and weighs 59 kg (130 lb) ; BMI is 23 kg/m2. Physical examination shows facial acne and growth of coarse dark hair on the face, chest, and lower back. Pelvic examination shows no abnormalities. Ultrasound examination of the pelvis reveals a normal uterus and ovaries.  Electrolytes are normal; other laboratory results are as follows: Which of the following enzyme reaction steps is most likely to be disrupted in this patient?

A) 11-deoxycorticosterone conversion to corticosterone
B) 11-deoxycortisol conversion to cortisol
C) Pregnenolone conversion to 17-hydroxypregnenolone
D) Progesterone conversion to 11-deoxycorticosterone
E) Testosterone conversion to estradiol

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