<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 37-year-old man comes to the physician for a follow-up examination. He is being evaluated for high blood pressure readings that were incidentally recorded at a routine health maintenance examination 1 month ago. He has no history of serious illness and takes no medications. His pulse is 88min and blood pressure is 16598 mm Hg. Physical examination shows no abnormalities. Serum studies show:Na 146 mEqLK 3.0 mEqLCl- 98 mEqLGlucose 77 mgdLCreatinine 0.8 mgdLHis plasma aldosterone concentration PAC to plasma renin activity PRA ratio is 36 N 10. A saline infusion test fails to suppress aldosterone secretion. A CT scan of the adrenal glands shows bilateral adrenal abnormalities. An adrenal venous sampling shows elevated PACs from bilateral adrenal veins. Which of the following is the most appropriate next step in management?? A: Amiloride therapy, B: Propranolol therapy, C: Unilateral adrenalectomy, D: Eplerenone therapy, E: Bilateral adrenalectomy,  <response>: This is a question about primary aldosteronism. The patient has hypertension, elevated aldosterone to renin ratio, failure of aldosterone suppression on saline infusion, bilateral adrenal abnormalities on CT, and elevated aldosterone secretion from both adrenal veins. This indicates bilateral adrenal hyperplasia as the cause of primary aldosteronism. The next step in management would be medical therapy with a mineralocorticoid receptor antagonist like eplerenone or spironolactone. Surgery is not indicated since both adrenal glands are involved. D: Eplerenone therapy 