NBME question about ACEi HELP - USMLE Forums
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Old 08-25-2016
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Default NBME question about ACEi HELP

67yo M with uncontrollable nosebleed for 6 hours. No Hx of HTN and takes no meds. Smokes 1-2 packs
for 45 years. BP is 220/120. Exam shows lesion in left naris controlled with cauterization. Bilateral bruits over
flank. Rental arteriography shows 13 cm kidneys with single renal arteries. Ostial lesions of both kidneys that
occlude 85% of vessel orifice. After ACE inhibitor, BP drops to 140/80. Mechanism of response?

I know the answer is -No cleaving of C-terminal peptides on angiotensin I and I know the explanation but I don't know why the answer I picked is wrong.
on the online NBME I bought I picked No aldosterone secretion from the adrenal cortex and I have no idea why this is wrong, anybody who can help explain this wrong answer better, thanks!
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