Primary aldosteronism — MCCQE Part 1 MCQ
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Correct answer: E — Screen with plasma aldosterone-renin ratio
Screen with plasma aldosterone-renin ratio is the single best answer because the age, timing, examination findings and investigations in the vignette fit Primary aldosteronism better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Hypertension Canada 2025, with attention to acuity, safety-netting and local provincial pathways.
Reference: Hypertension Canada 2025