nbme 18 question

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Northerncardinal

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plz help

A 60 yr old man comes to the dr for health maintenance examination. He has had normal blood pressure measurements. His BP today is 170/95 mm Hg. Physical exam shows no abnormalities. Serum studies show hypokalemia and metabolic alkalosis. Plasma renin and serum aldo concentrations are increased. Following administration of captopril, there is marked increase in plasma renin activity. Which of the following is the most likely cause of the findings in this patient?

A. Aldosterone secreting adrenal tumour
B. Chronic glomerulonephritis.
C. Cushing syndrome
D. Essential HTN
E. Renal artery stenosis

The corrent answer is E.

However, I'm debating between D vs. E. cuz Captopril would result in inc renin in any patient not specifically pts with renal artery stenosis.

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