A 66-Year-Old Man Comes to the Office for a Routine

A 66-year-old man comes to the office for a routine visit.  He has no current complaints.  The patient has a history of poorly controlled type 2 diabetes mellitus and hypertension.  His blood work from 2 months ago showed hyperkalemia, and lisinopril was discontinued at that time.  The patient's current medications include glipizide, furosemide, nifedipine, and aspirin.  His blood pressure is 150/90 mm Hg and pulse is 78/min.  Examination is unremarkable.  Repeat blood test results today are as follows: Which of the following is the most likely cause of this patient's electrolyte abnormalities?

A) Furosemide use
B) Laxative abuse
C) Pre-renal azotemia
D) Primary hyperaldosteronism
E) Renal artery stenosis
F) Renal tubular acidosis
G) Surreptitious vomiting

Correct Answer:

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