A Young Female with Flank Pain

A 28-year old woman comes to the physician complaining about right flank pain. She is afebrile and her blood pressure is 150/98 mm Hg. She has a history of hypertension treated with an angiotensin-converting-enzyme inhibitor in the past two years. She also complains about frequent headaches which most of the time have been relieved with over-the-counter medications. She also complains about intermittent vision problems that resolve spontaneously after a few seconds. Her recent laboratory studies from a routine check-up have revealed 1.1 mg/dl Creatinine level,95 mg/dl LDL and 53 mg/dl HDL. An abdominal X-ray is ordered and is unremarkable. The remaining physical examination is unrevealing. She is not smoking and denies using illicit drugs, although she reveals that she used to smoke marijuana in college. She drinks one glass of wine every weekend. Her father has a history of stroke at age 63 and her mother has a history of migraines. She has a 3-year monogamous relationship and uses condoms consistently.

Which of the following would be most likely to co-exist in this patient?

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