A 42-Year-Old Man Comes to the Office Due to Increased

A 42-year-old man comes to the office due to increased abdominal girth associated with a 9-kg (19.8-lb) weight gain over the past month.  He drinks a liter of vodka daily and denies smoking or using intravenous drugs.  Blood pressure is 110/70 mm Hg.  The abdomen is moderately distended, and a fluid wave is elicited.  Multiple spider angiomas are present.  Laboratory studies reveal thrombocytopenia, hypoalbuminemia, a normal sodium level, and an elevated PT.  An upper endoscopy is performed, which shows no esophageal or gastric varices.  Pharmacotherapy aimed at inhibiting which of the following should be considered for this patient?

A) Aldosterone
B) Alpha-adrenergic receptors
C) Angiotensin
D) Antidiuretic hormone
E) Prostaglandins

Correct Answer:

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