Morning Quiz ☕️ 

(Difficulty level - Low )

A 49-year-old woman presents to the urgent care clinic with:

Chief complaint: Palpitations for the past few hours

Associated symptoms:

• Denies chest pain, shortness of breath, and sweating

• Appears anxious and worried

Medical History

• Mild bronchial asthma

• Uses inhaler only during attacks (last used a week ago)

• Former smoker

• Drinks a couple of beers on weekends

No other significant medical history

Vital Signs

• Heart rate: 136/min

• Respiratory rate: 16/min

• Temperature: 37.6°C (99.7°F)

• Blood pressure: 120/80 mm Hg

Physical Examination

• Unremarkable

Next Step

• An electrocardiogram (ECG) is ordered.

Question

Which of the following groups of drugs would be appropriate to treat this patient’s symptoms?

A. α1-receptor antagonist

B. Selective β1-receptor antagonist

C. Non-selective β-receptor antagonist

D. α-receptor agonist

E. β-receptor agonist

Correct Answer 🎯: B. Selective ß1-receptor antagonist

⚙️

Trigger (Cause of Palpitations)
⬇
Anxiety / Sympathetic Overdrive (no structural heart disease, no acute ischemia)
⬇
↑ Sympathetic Stimulation → ↑ Catecholamines (NE/Epi)
⬇
Activation of β₁-Receptors (Heart) → ↑ cAMP → ↑ Ca²⁺ Influx
⬇
↑ Myocardial Contractility & ↑ SA Node Firing Rate
⬇
Sinus Tachycardia (HR 136/min)
⬇
Palpitations (Perceived Rapid Heartbeat)

Differential Table ⚖️

Practice Questions ⏳️ 

Most importantly solve Uworld with QIDs

898, 19577

Your Brother in This Struggle

Dr. Shoaib Ahmad