06-16-2010, 05:57 PM
34. A healthy 27-year-old woman comes for a routine
health
maintenance examination. Her blood pressure is 185/90
mm Hg. Examination shows
no other abnormalities except for hypertensive
retinopathy. Serum
studies show a sodium level of 140 mEq/L, potassium
level of 4 mEq/L, and
creatinine level of 1.1 mg/dL. A complete blood
count, serum
catecholamine levels, and urinalysis are within normal
limits. At two subsequent
visits, her blood pressure is 190/100 mm Hg and 182/96
mm Hg,
respectively. Which of the following is the most
appropriate next step in
diagnosis?
A
) 24-Hour urine collection for measurement of
creatinine clearance
B
) 24-Hour urine collection for measurement of
17-hydroxycorticosteroid and total 17-ketosteroid
levels
C
) Measurement of serum aldosterone level
D
) Magnetic resonance angiography of renal vessels
E
) CT scan of the abdomen