A 25-year-old male presents to the emergency depament with occasional severe headaches, nausea, and vomiting. Blood pressure while sitting is 230/130 mmHg with a hea rate of 90 beats/min but on standing the blood pressure drops to 200/100 mmHg and the hea rate increases to 140 beats/min. A cardiovascular examination depicted tachycardia with normal S1, S2 sounds . The patient’s lungs are clear. The optic discs are blurred, but there are no exudates or hemorrhages. Select appropriate treatment for such condition .
Correct Answer: Phentolamine
Description: If SBP gets reduced by >20mmHg & DBP get reduced by >10mmHg On change of posture=Postural or Ohostatic Hypotension * |HR * Headache+ HTN * In early phase, the BP will be elevated for few min-hours i.e. Episodic HTN * In late phase, the BP will show postural hypotension. All are Features of Pheochromocytoma [?] Phentolamine Option A & B- used in HTN encephalopathy (Unconsciousness, brisk reflexes) Option D- can l/t reflex tachycardia which ||HR
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