CAH and ambigious genitalia

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a gonad that is found in the inguinal cana or lbio scrotal fold is a testis if it's an abdomen it it can either be a testes or an ovaries
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PCOS doesnt cause fetal virilization r because androgen isn't enough and the placenta has a natural mechanism of protection by aromatizing androgens to estrogen but it cannot do this for congenital adrenal hyperplasia
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Males also can have Cah but the excess androgens won't affect them clinically
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The mullerian duct isnt destroyed because there is no AMH to destroy it but the wolffian duct isnt formed because by the time the adrenal glands develop and testesterone levels increase the wolffian duct has already regressed.
the wolfian ducts leads to seminal vesicles, vas deferenas etc so thats why CAH has only externa gentialisa of male only and not internal.
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the most severe form the salt wasting form leads to the deficiency of other hormones as wel;, the corticosteriods and the minerelosteroids so they ha ve those deficinency as well
 
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The vrilisation needs to be corrected with srugery like pastic sugery and cosmetically only
hydrocortisone is much short asting and used in new borns
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cant give th eother steroidal drugs because they dont cross the placenta or are metabolised by the placenta.
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first must determine the gentic test to see what needs to be done next
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this condition can cause adrenal insuffiency also.
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Male fetus being under virilised causes ⇒ any ause along the chain from deficiency of androgen production to androgen insesntivity ⇒ vareity of causes and beyond the course
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IF unquivocal then can use ACTH stimulation and if it increases the levels a lot then it can be the enzyme defiency!