<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 37-year-old female presents to the emergency room complaining of headaches and palpitations. She reports that she initially started experiencing these symptoms several months prior but attributed them to stress at work. The symptoms occur episodically. Her family history is notable for medullary thyroid cancer and hyperparathyroidism. Her temperature is 98.6F 37C, blood pressure is 16590 mmHg, pulse is 105min, and respirations are 18min. On examination she appears tremulous. Urine metanephrines are elevated. Which of the following is the most appropriate first medication in the management of this patients condition?? A: Phenoxybenzamine, B: Propranolol, C: Phentolamine, D: Tamsulosin, E: Atenolol,  <response>: Based on the information provided in the question stem, this patient is presenting with symptoms of episodic headaches, palpitations, tremors, elevated blood pressure, and elevated urine metanephrines. The key findings are the episodic nature of symptoms, family history of medullary thyroid cancer and hyperparathyroidism, vital sign abnormalities including hypertension and tachycardia, and elevated urine metanephrines. This clinical presentation is most consistent with pheochromocytoma, a catecholamine-secreting tumor that can lead to episodic release of epinephrine and norepinephrine. The most appropriate initial medication management is with an alpha-blocker such as phenoxybenzamine to control blood pressure and counteract catecholamine-induced vasoconstriction. Beta-blockers like propranolol and atenolol would be contraindicated as initial therapy since unopposed alpha-stimulation could lead to hypertensive crisis. Phentolamine and tamsulosin do not have a clear role in initial management.A: Phenoxybenzamine 