## **Core Concept**
Phaeochromocytomas are rare tumors of the adrenal gland that cause excessive production of catecholamines, leading to hypertension. Managing hypertension in phaeochromocytoma requires careful consideration of the underlying pathophysiology.

## **Why the Correct Answer is Right**
The correct answer, **Prazosin**, is a non-selective alpha-blocker. It is the drug of choice for managing hypertension in phaeochromocytoma because it blocks the alpha-1 adrenergic receptors, thereby reducing vascular tone and blood pressure. This is crucial in phaeochromocytoma, where hypertension is caused by excessive catecholamine release. Alpha-blockers like prazosin are used before surgery to control blood pressure and prevent hypertensive crises.

## **Why Each Wrong Option is Incorrect**
* **Option A:** Propranolol is a beta-blocker. While it can be used to control tachycardia associated with phaeochromocytoma, it should not be used alone to manage hypertension because it can cause unopposed alpha-adrenergic receptor stimulation, leading to worsening hypertension.
* **Option B:** Metoprolol is also a beta-blocker and has similar limitations to propranolol in the context of phaeochromocytoma.
* **Option D:** Nifedipine is a calcium channel blocker. While it can be used to manage hypertension, it is not the first choice for phaeochromocytoma because it does not address the underlying pathophysiology as directly as alpha-blockers.

## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that beta-blockers should only be initiated after adequate alpha-blockade has been established in patients with phaeochromocytoma. This is to prevent a sudden increase in blood pressure due to unopposed alpha-adrenergic stimulation.

## **Correct Answer:** . Prazosin