<prompt> A 20 year old female presents with a blood pressure of 160110 mm Hg. Clinical examination reveals a bruit in both flanks. Which of the following statement about this patient is not true?Enalapril may deteriorate renal functionMost definitive diagnostic procedure is contrast enhanced angiographyCondition is nearly always bilateralSurgical intervention may be used  <response>: 20 year old female presenting with high BP and abdominal bruit on both flanks possibly point to a diagnosis of renal aery stenosis secondary to fibromuscular dysplasia. All the choices given are almost correct, among the choices given c would be a better choice. Because it is usually bilateral and not nearly always bilateral. Ref: Harrisons 18e p2375, 17e p1811-1812 