Disorders of sex development — branching viva

Neonatal unit: a two-week-old infant recorded as male at birth with severe hypospadias and bilaterally impalpable gonads, now vomiting and dehydrated, with a sodium of 122, potassium of 6.8, glucose of 1.6, and hyperpigmented scrotal skin. The examiner asks: what is the diagnosis, which bedside finding orients it, and what is the immediate and long-term plan — then branches to the karyotype result, the surgical deferral question, and finally to a sixteen-year-old with primary amenorrhoea and a 46,XY karyotype.