Hypertension Quiz

A 20-year-old female is referred for work-up of newly diagnosed hypertension.

Laboratory Studies

Serum sodium 144 mEq/L

Serum potassium 3.2 mEq/L

Serum chloride 107 mEq/L

Serum bicarbonate 29 mEq/L

Blood urea nitrogen 19 mg/dL

Serum creatinine 1 mg/dL

Plasma renin activity 0.8 ng/mL/hr (Normal range 1-6)

Plasma aldosterone 4.2 ng/dL (Normal range 5-20)

Which of the following tests would be appropriate to send next:

A. 24 hr urine aldosterone

B. 24 hr urine cortisol

C. 24 hr urine 18-hydroxycortisol and 18-oxocortisol

D. Doppler ultrasound of the renal arteries

E. Serum metanephrines