**Core Concept**
Medical adrenalectomy refers to the pharmacological suppression of adrenal hormone production, particularly cortisol and aldosterone, achieved through the use of medications. This approach is employed in various clinical scenarios, including the management of Cushing's syndrome and hypertension.

**Why the Correct Answer is Right**
The correct answer involves the use of spironolactone, a potassium-sparing diuretic that also possesses mineralocorticoid receptor antagonist properties. By blocking the action of aldosterone, spironolactone leads to decreased sodium reabsorption and increased potassium excretion in the kidneys. This effect results in a reduction in blood pressure and aldosterone-mediated effects. Additionally, the use of ketoconazole, a cytochrome P450 enzyme inhibitor, can further contribute to the suppression of adrenal hormone production, including cortisol.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect as it does not accurately represent a medication used for medical adrenalectomy.
* **Option B:** This option is incorrect as it is a medication primarily used for hypertension and does not possess mineralocorticoid receptor antagonist properties.
* **Option C:** This option is incorrect as it is a medication primarily used for the treatment of hypothyroidism and not for medical adrenalectomy.

**Clinical Pearl / High-Yield Fact**
When considering medical adrenalectomy, it is essential to remember that spironolactone can cause hyperkalemia, particularly in patients with underlying renal impairment. Regular monitoring of serum potassium levels is crucial to prevent this adverse effect.

**Correct Answer:** D. Spironolactone.