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NEW QUESTION: 1
A 48-year-old man was referred by his general practitioner, whose letter stated: 'Please review this man's blood pressure management, as he has requested a second opinion, having seen information on the internet about the need for more detailed investigation. He has been having treatment for 10 years.'
At the consultation, the patient confirmed that he was currently taking bendroflumethiazide
2.5 mg daily, atenolol 50 mg daily and perindopril 8 mg daily. His clinic blood pressure was 169/108 mmHg. Clinical examination was otherwise normal.
Investigations:
serum sodium142 mmol/L (137-144)
serum potassium3.9 mmol/L (3.5-4.9)
estimated glomerular filtration rate (MDRD)>60 mL/min/1.73 m2 (>60)
ambulant plasma renin activity0.5 pmol/mL/h (3.0-4.3)
ambulant plasma aldosterone380 pmol/L (330-830)
What is the most appropriate next step in management?
A. CT scan of adrenal glands
B. add amlodipine
C. urine steroid profile
D. fludrocortisone suppression test
E. withdraw atenolol and repeat renin and aldosterone
Answer: E

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C. display ap version id x (x is the ID number of the AP)
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