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NBME 19 Answers

nbme19/Block 3/Question#34 (8.2 difficulty score)
52 yo man, 4 hours of severe headache, ...
Increased total peripheral resistance and decreased cardiac outputπŸ”

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submitted by cassdawg(959),

Propanolol is a nonselective beta blocker:

  • Blockade of beta-1 receptors: beta-1 typically cause an increase in heart rate, so blockade causes decrease in heart rate and contractility. CO = HR x SV so there is an overall decrease in cardiac output
  • Blockade of beta-2 receptors: beta-2 receptors normally cause relaxation of smooth muscle and vasodilation, so blockade causes constriction and therefore increases total peripheral resistance (decreased radius leads to increased resistance)
waitingonprometric  giving a non-selective beta blocker will cause unopposed alpha effects (i.e. vasoconstriction), this is the opposite of what you want in this patient +