This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Cardiovascular system, Subject name: Pharmacology
ACE inhibitors are contraindicated in 
Select and explain. 
A. Diabetes mellitus, B. Hypeension in age old patient, C. Scleroderma, D. Bilateral renal aery stenosis
D: Bilateral renal aery stenosis
Answer: D: Bilateral renal aery stenosis 
Explanation: Refer kDT 6/e p 484 Angiotensin-conveing enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal aery stenosis due to risk of azotemia resulting from preferential efferent aeriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II.