Examen Integrado - Medicina Practice Questions - Argentina Medical Residencies Integrated Examination (Examen Integrado De Residencias De La Salud - Medicina) Exam

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A 34-year-old woman is evaluated for treatment-resistant hypertension. Despite adherence to a three-drug regimen including amlodipine 10 mg, valsartan 160 mg, and hydrochlorothiazide 25 mg daily, her office blood pressure remains 168/104 mmHg. Routine laboratory testing reveals serum potassium 2.9 mEq/L, sodium 144 mEq/L, and serum bicarbonate 31 mEq/L. She is not taking licorice or laxatives. What is the MOST appropriate initial screening test for the suspected secondary etiology?

Morning plasma aldosterone-to-renin ratio (ARR) 24-hour urinary free cortisol excretion Renal duplex ultrasonography for renal artery stenosis 24-hour urinary fractionated metanephrines and normetanephrines

Correct Answer:

Morning plasma aldosterone-to-renin ratio (ARR)

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