A 35-Year-Old Woman Is Being Evaluated for Uncontrolled Hypertension

A 35-year-old woman is being evaluated for uncontrolled hypertension.  She was recently diagnosed with diabetes mellitus.  Medical history is significant for mood swings.  Temperature is 36.7 C (98 F) , blood pressure is 150/100 mm Hg, pulse is 88/min, and respirations are 14/min.  Lungs are clear on auscultation bilaterally, and the heart rhythm is regular.  Abdominal auscultation fails to reveal any bruit.  All peripheral pulsations are full.  Laboratory results are as follows: Chest x-ray is suggestive of dorsal vertebral osteopenia.  Which of the following is the most appropriate investigation?

A) Duplex scanning of renal vessels
B) Spiral CT of chest
C) Urinary catecholamine measurements
D) Aldosterone and renin estimation
E) Dexamethasone suppression test

Correct Answer:

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