Review Question - QID 214795

A 41-year-old woman presents to her primary care physician with a 2-month history of headache. She says that the headache will occur sporadically, and she cannot identify a specific trigger that makes them occur. She describes the headache as bilateral pounding pain that is 9/10 in severity. In addition, she describes having palpitations during these episodes that make her extremely anxious because her father died of a heart attack. Her past medical history is significant for diabetes for which she is taking metformin, and her family history is significant for kidney and thyroid problems. On presentation, her temperature is 98.6°F (37°C), blood pressure is 180/135 mmHg, pulse is 105/min, and respirations are 17/min. Which of the following best describes the pathophysiology underlying this patient's symptoms?