Diabetes Mellitus USMLE Step 1 Practice Question
A 67-year-old man with severe atherosclerotic disease and type 2 diabetes presents with refractory hypertension despite lisinopril and amlodipine. Vital signs show BP 178/102 mmHg, HR 88/min, RR 16/min, temperature 37.2°C. Laboratory studies reveal markedly elevated plasma renin activity and elevated aldosterone levels. Serum creatinine is 1.3 mg/dL. A systolic abdominal bruit is appreciated on examination. No lower extremity edema is noted. Which of the following is the most likely underlying cause?
Answer choices
- AAutoimmune destruction of the adrenal cortex
- BPrimary polydipsia
- CBilateral renal artery stenosisCorrect answer
- DPituitary ACTH excess
- EAdrenal adenoma producing aldosterone
- FUnilateral renal artery stenosis with a solitary contralateral kidney
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