A healthy 27-year-old woman comes for a routine health maintenance examination

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

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