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20 Cards in this Set
- Front
- Back
Key History -
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Duration
location - esp. u/l vs. b/l quality intensity timing - disturb sleep? associated neuro Sxs nausea jaw claudication recent trauma dental surgery sinusitis Sxs exacerbating factors - stress fatigue menses exercise alleviating factors - rest medicines past h/o headache family h/o migraines |
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Key PE -
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VS
inpection and palpation of entire head ENT inspection complete neuro exam, including funduscopic |
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21 y/o F
presents with several episodes of throbbing left temporal pain that lasts for 2-3 hrs. Prior to its onset, she sees flashes of light in her right visual field. She feels weakness and numbness on the right side of her body for a few minutes. Headaches are often associated with n/v. She has family h/o migraine. What is Differential? |
Migraine (complicated)
tension headache cluster headache pseudotumor cerebri trigeminal neuralgia CNS vasculitis partial seizure intracranial neoplasm |
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21 y/o F
presents with several episodes of throbbing left temporal pain that lasts for 2-3 hrs. Prior to its onset, she sees flashes of light in her right visual field. She feels weakness and numbness on the right side of her body for a few minutes. Headaches are often associated with n/v. She has family h/o migraine. What is Workup? |
CBC
ESR CT - head MRI - brain LP |
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26 y/o M
presents with terrible right temporal headaches associated with ipsilateral rhinorrhea and eye tearing and redness. Episodes have occurred at the same time every night for the past wk. and last for 45 mins. What is Differential? |
Cluster headache
migraine tension headache sinusitis pseudotumor cerebri trigeminal neuralgia intracranial neoplasm |
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26 y/o M
presents with terrible right temporal headaches associated with ipsilateral rhinorrhea and eye tearing and redness. Episodes have occurred at the same time every night for the past wk. and last for 45 mins. What is Workup? |
CBC
ESR CT - head MRI - brain LP |
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65 y/o F
presents with severe, intermittent right temporal headache, fever, blurred vision in her right eye and pain in her jaw when chewing. What is Differential? |
Temporal arteritis (giant cell arteritis)
migraine cluster headache tension headache meningitis carotid artery dissection pseudotumor cerebri trigeminal neuralgia intracranial neoplasm |
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65 y/o F
presents with severe, intermittent right temporal headache, fever, blurred vision in her right eye and pain in her jaw when chewing. What is Workup? |
CBC
ESR CRP temporal artery Bx doppler US - carotid MRI - brain |
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30 y/o F
presents with frontal HA, fever and nasal discharge. Pain on palpation of frontal and maxillary sinuses. She has a h/o sinusitis. What is Differential? |
Sinusitis
migraine tension HA meningitis intracranial neoplasm |
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30 y/o F
presents with frontal HA, fever and nasal discharge. Pain on palpation of frontal and maxillary sinuses. She has a h/o sinusitis. What is Workup? |
CBC
CT - sinus LP |
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50 y/o F
presents with recurrent episodes of b/l squeezing HA that occur 3-4/week. She's experiencing significant stress in her life What is Differential? |
Tension HA
migraine depression caffeine or analgesic withdrawal HTN cluster HA pseudotumor cerebri intracranial neoplasm |
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50 y/o F
presents with recurrent episodes of b/l squeezing HA that occur 3-4/week. She's experiencing significant stress in her life What is Workup? |
CBC
electrolytes ESR CT - head LP |
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35 y/o M
presents with severe HA, vomiting, confusion, left hemiplegia and nuchal rigidity What is Differential? |
SAH
migraine meningitis/encephalitis intracranial hemorrhage vertebral artery dissection intracranial venous thrombosis acute HTN intracranial neoplasm |
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35 y/o M
presents with severe HA, vomiting, confusion, left hemiplegia and nuchal rigidity What is Workup? |
CT - head
LP CBC PT/PTT MRI/MRA - brain |
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25 y/o M
presents with high fever, severe HA, confusion, photophobia and nuchal rigidity. Kernig's and Brudzinski's signs are positive. What is Differential? |
Meningitis
migraine SAH sinusitis/encephalitis intracranial or epidural abscess |
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25 y/o M
presents with high fever, severe HA, confusion, photophobia and nuchal rigidity. Kernig's and Brudzinski's signs are positive. What is Workup? |
CBC
CT - head MRI - brain LP - CSF analysis |
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18 y/o obese F
presents with HA, vomiting, blurred vision for the past 2-3 weeks. She is taking OCPs. What is Differential? |
Pseudotumor cerebri
tension HA migraine cluster HA meningitis intracranial venous thrombosis intracranial neoplasm |
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18 y/o obese F
presents with HA, vomiting, blurred vision for the past 2-3 weeks. She is taking OCPs. What is Workup? |
Urine hCG
CBC CT - head LP - opening pressure and CSF analysis |
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47 y/o M
c/o daily pain in the right cheek over the past month. The pain is electric in character and occurs while he's shaving. Each episode lasts 2-4 mins. What is Differential? |
Trigeminal neuralgia
tension HA migraine cluster HA TMJ dysfunction intracranial neoplasm |
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47 y/o M
c/o daily pain in the right cheek over the past month. The pain is electric in character and occurs while he's shaving. Each episode lasts 2-4 mins. What is Workup? |
CBC
ESR MRI - brain |