Free ABIM Internal Medicine Practice Questions
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A 45-year-old female is evaluated for resistant hypertension and a persistent serum K⁺ of 3.1 mEq/L despite being on Lisinopril and AmlodipinE. Screening tests show a plasma aldosterone concentration (PAC) of 25 ng/dL and a plasma renin activity (PRA) of 0.4 ng/mL/h. After salt loading, the aldosterone remains elevated at 18 ng/dL. A CT of the adrenals shows a 1.2 cm left adrenal nodule and a normal right gland. Adrenal vein sampling is performed. The cortisol-corrected aldosterone ratio from the left vein to the right vein is 1.5:1. What is the most appropriate next step?
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