American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the common clinical presentation of virilization in adrenal disorders?

1. Increased stress response

2. Delayed puberty

3. Precocious puberty

4. Decreased muscle mass

The correct answer is: Precocious puberty

Virilization in adrenal disorders is characterized by the development of male secondary sexual characteristics in individuals, which can occur in both sexes as a result of excessive androgen production. This can manifest as premature development of features typically associated with male maturity, such as increased body hair, deepening of the voice, and other traits related to testosterone effects. Precocious puberty refers specifically to the early onset of secondary sex characteristics before the typical age, which is particularly relevant in the context of adrenal disorders where high levels of androgens can accelerate sexual maturation. Typically, in girls, this can include breast development, menstruation, and features of virilization. The other options — increased stress response, delayed puberty, and decreased muscle mass — do not reflect the effects of virilization. Increased stress response may be observed in conditions like adrenal insufficiency rather than virilization. Delayed puberty is characterized by the absence of secondary sex characteristics at the expected age and is not consistent with excessive androgen levels seen in adrenal virilization. Decreased muscle mass is often associated with low levels of androgens rather than the increased levels that drive virilization. Thus, the common clinical presentation of virilization aligns with precocious puberty due to increased androgen production in