NBME 2 A 42-year-old woman comes - khushigrover

[ArchivalUser]

17.

A 42-year-old woman comes for a follow-up examination.
Two weeks ago,
her blood pressure was 152/94 mm Hg during a routine
visit. Her blood
pressure today is 150/94 mm Hg, pulse is 76/min, and
respirations are
14/min. Examination shows no other abnormalities.
Serum studies show:


Na+ 142 mEq/L
Cl“ 105 mEq/L
K+ 4 mEq/L
HCO3“ 26 mEq/L
Urea nitrogen (BUN) 12 mg/dL
Glucose 101 mg/dL
Creatinine 0.8 mg/dL

An ECG shows no abnormalities. Which of the following
is the most
appropriate next step in management?

A
) Measurement of plasma renin activity

B
) Serum lipid studies

C
) 24-Hour urine collection for measurement of
metanephrine level

D
) Echocardiography

E
) Captopril renal scan

[ArchivalUser]

Before treatment we need a better picture of the possible causes. B I think?

[ArchivalUser]

ANS KEY SAYS..A/E...but in this pt is there any need of doing renin levels /scan.he is jst coming for routine exam and his electrolytes levels are also normal?????????/