A 52-Year-Old Man Comes to the Office Due to Easy

A 52-year-old man comes to the office due to easy bruisibility and muscle weakness.  Medical history is unremarkable, but the patient has smoked a pack of cigarettes daily for 30 years.  Blood pressure is 160/110 mm Hg, and pulse is 80/min.  BMI is 29 kg/m².  Physical examination shows facial plethora, slight centripetal distribution of body fat, diffuse skin pigmentation, and bilateral peripheral edema.  Fasting blood glucose is 160 mg/dL and creatinine is 1.2 mg/dL.  Chest x-ray reveals a lung mass.  Which of the following is the most likely cause of this patient's elevated blood pressure?

A) Activation of renal mineralocorticoid receptors
B) Elevated plasma catecholamine level
C) Impaired glomerular filtration of sodium and water
D) Marked urinary loss of albumin
E) Renal resistance to antidiuretic hormone

Correct Answer:

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