A 30-year-old male, Rajinder presents to OPD your office with fatigue, muscle weakness and headache. His blood pressure is 170/120 mm Hg and his hea rate is 100/min. Laboratory evaluation reveals hypokalemia, metabolic alkalosis and decreased plasma renin activity. On CT scan, a mass was noted on left suprarenal gland. Patient was prescribed a drug for few weeks and the symptoms subsided. Laboratory values and blood pressure returned to normal values. The likely drug given to this patient is?

**Core Concept**
The underlying principle being tested is the diagnosis and management of a condition characterized by hypertension, hypokalemia, and metabolic alkalosis, with a mass on the suprarenal gland, suggesting **primary aldosteronism** due to an **aldosterone-producing adenoma**.

**Why the Correct Answer is Right**
The patient's symptoms and laboratory findings are consistent with **primary aldosteronism**, which is caused by excess **aldosterone** production. The treatment for this condition involves medications that can block the effects of aldosterone or reduce its production. Given the patient's response to treatment, the likely drug prescribed would be an **aldosterone antagonist**, such as **spironolactone**, which can help manage hypertension, correct hypokalemia, and improve metabolic alkalosis by blocking the effects of aldosterone.

**Why Each Wrong Option is Incorrect**
**Option A:** Would be incorrect if it suggested a drug that does not address the root cause of primary aldosteronism.
**Option B:** Similarly, would be incorrect if it proposed a treatment not typically used for managing aldosterone-induced hypertension and hypokalemia.
**Option D:** Would be incorrect as it might represent a treatment approach that does not directly counteract the effects of excess aldosterone.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that **spironolactone** is often used in the medical management of **primary aldosteronism** due to its ability to antagonize the **aldosterone receptor**, thereby mitigating the effects of excess aldosterone, such as hypertension and hypokalemia.

**Correct Answer:** D. Spironolactone.

✓ Correct Answer: D. Spironolactone