<prompt> An 8 days old male infant is brought to the emergency depament with vomiting, lethargy, dehydration and features of shock. Clinical examination reveals hyperpigmentation of the genital skin and normal external genitalia. Abdominal examination is unremarkable. Blood tests revealed sodium of 124 meql, potassium of 7 meq1 and hypoglycemia. Which of the following is the most likely diagnosis:Congenital Adrenal Hyperplasia CAHAdrenal HaemorrhageAcute Gastorenteritis with dehydrationHyperaldosteronism  <response>: Ans is a i.e., Congenital Adrenal Hyperplasia CAH Presence of vomiting, lethargy, dehydration, hyponatremia, hyperkalemia, hypoglycemia and shock in this eight year old male infant suggest a diagnosis of neonatal adrenal insufficiencycrisis. Congenital Adrenal Hyperplasia is the most prevalent cause of adrenal insufficiency in neonates typically 7-14 days post delivery and the single best answer amongst the options provided. Clinical features of CAH 21 hvdroxlose deficiency o Symptoms of classical CAH due to 21 hydroxylase deficiency are: i Clinical: Lethargy, vomiting, Anorexia, weight loss, dehydration, hypotension, shock ii Mineralocoicoid deficiency: Hyponatremia, hyperkalemia, hypotension iii Coisol deficiency: Hypoglycemia, Hyperpgimention of areolar and scorial areas in males and genital creases in females due to T ACTH secretion iv Excess Androgen Males: Phenotypically normal for some years, precocious pubey Females: Virilization female pseudohermophrodite 