03-24-2009, 12:23 PM
41. A 70-year-old man comes to the physician because of discomfort in his lower abdomen for 1 week. Use of over-the-counter ibuprofen has not relieved the symptoms. He has a 25-year history of hypertension currently treated with quinapril. His pulse is 90/min and regular, and blood pressure is 140/80 mm Hg. The lungs are clear to auscultation. Cardiac examination shows no murmurs or gallops. There is a 7-cm mass extending superiorly from the symphysis pubis in the midline. Serum studies show a urea nitrogen (BUN) concentration of 60 mg/dL and a creatinine concentration of 4.5 mg/dL. Ultrasonography of the kidneys shows bilateral hydronephrosis. Which of the following is the most likely cause of this patient's laboratory findings?
A
) Angiotensin-converting enzyme (ACE) inhibitor therapy
B
) Glomerulonephritis
C
) Nonsteroidal anti-inflammatory drug therapy
D
) Prerenal azotemia
E
) Urethral obstruction
A
) Angiotensin-converting enzyme (ACE) inhibitor therapy
B
) Glomerulonephritis
C
) Nonsteroidal anti-inflammatory drug therapy
D
) Prerenal azotemia
E
) Urethral obstruction