Headache and stuff

cubutoga's version from 2015-09-03 04:52


Question Answer
21 yo F presents with several episodes of throbbing left temporal pain that lasts for 2–3 hours. Prior to its onset, she sees flashes of light in her right visual field and feels weakness and numbness on the right side of her body for a few minutes. Headaches are often associated with nausea and vomiting. She has a family history of migraine.Migraine (complicated)-Tension headache -Cluster headache-Pseudotumor cerebri-Trigeminal neuralgia -CNS vasculitis-Partial seizure- Intracranial neoplasm
26 yo M presents with severe right temporal headaches associated with ipsilateral rhinorrhea, eye tearing, and redness. Episodes have occurred at the same time every night for the past week and last for 45 minutes.Cluster headache- Migraine -Tension headache- Sinusitis -Pseudotumor cerebri -Trigeminal neuralgia -Intracranial neoplasm
65 yo F presents with severe, intermittent right temporal headache, fever, blurred vision in her right eye, and pain in her jaw when chewing.Temporal arteritis (giant cell arteritis)- Migraine -Cluster headache -Tension headache- Meningitis- Carotid artery dissection- Pseudotumor cerebri -Trigeminal neuralgia- Intracranial neoplasm
30 yo F presents with frontal headache, fever, and nasal discharge. There is pain on palpation of the frontal and maxillary sinuses. She has a history of sinusitis.Sinusitis- Migraine- Tension headache- Meningitis -Intracranial neoplasm
50 yo F presents with recurrent episodes of bilateral squeezing headaches that occur 3–4 times a week, typically toward the end of her work day. She is experiencing significant stress in her life.Tension headache- Migraine- Depression -Caffeine or analgesic withdrawal -Hypertension -Cluster headache- Pseudotumor cerebri -Intracranial neoplasm
35 yo M presents with sudden severe headache, vomiting, confusion, left hemiplegia, and nuchal rigidity.Subarachnoid hemorrhage- Migraine -Meningitis/encephalitis- Intracranial hemorrhage- Vertebral artery dissection -Intracranial venous thrombosis -Acute hypertension- Intracranial neoplasm
25 yo M presents with high fever, severe headache, confusion, photophobia, and nuchal rigidity. Kernig’s and Brudzinski’s signs are positive.Meningitis- Migraine- Subarachnoid hemorrhage -Sinusitis/encephalitis- Intracranial or epidural abscess
18 yo obese F presents with a pulsatile headache, vomiting, and blurred vision for the past 2–3 weeks. She is taking OCPs.Pseudotumor cerebri- Tension headache- Migraine -Cluster headache- Meningitis -Intracranial venous thrombosis -Intracranial neoplasm
57 yo M c/o daily pain in the right cheek over the past month. The pain is electric and stabbing in character and occurs while he is shaving. Each episode lasts 2–4 minutes.Trigeminal neuralgia - Tension headache- Migraine - Cluster headache -TMJ dysfunction- Intracranial neoplasm
81 yo M presents with progressive confusion over the past several years together with forgetfulness and clumsiness. He has a history of hypertension, diabetes mellitus, and two strokes with residual left hemiparesis. His mental status has clearly worsened after each stroke (stepwise decline in cognitive function).Vascular (“multi-infarct”) dementia -Alzheimer’s disease- Normal pressure hydrocephalus- Chronic subdural hematoma -Intracranial tumor -Depression- B12 deficiency -Neurosyphilis -Hypothyroidism
84 yo F brought by her son c/o forgetfulness (e.g., forgets phone numbers, loses her way back home) along with difficulty performing some of her daily activities (e.g., bathing, dressing, managing money, using the phone). The problem has gradually progressed over the past few years.Alzheimer’s disease -Vascular dementia -Depression -Hypothyroidism -Chronic subdural hematoma -Normal pressure hydrocephalus- Intracranial neoplasm -B12 deficiency -Neurosyphilis
72 yo M presents with memory loss, gait disturbance, and urinary incontinence for the past six months.Normal pressure hydrocephalus -Alzheimer’s disease -Vascular dementia -Chronic subdural hematoma -Intracranial neoplasm- Depression- B12 deficiency -Neurosyphilis -Hypothyroidism
55 yo M presents with a rapidly progressive change in mental status, inability to concentrate, and memory impairment for the past two months. His symptoms are associated with myoclonus and ataxia.Creutzfeldt-Jakob disease -Vascular dementia -Lewy body dementia- Wernicke’s encephalopathy- Normal pressure hydrocephalus -Chronic subdural hematoma -Intracranial neoplasm -Depression -Delirium- B12 deficiency- Neurosyphilis
70 yo insulin-dependent diabetic M presents with episodes of confusion, dizziness, palpitation, diaphoresis, and weakness.Hypoglycemia -Transient ischemic attack -Arrhythmia -Delirium- Angina
55 yo F presents with gradual altered mental status and headache. Two weeks ago she slipped, hit her head on the ground, and lost consciousness for two minutes.Subdural hematoma- SIADH (causing hyponatremia)- Creutzfeldt-Jakob disease -Intracranial neoplasm
68 yo M presents with a two-month history of crying spells, excessive sleep, poor hygiene, and a 7-kg weight loss, all following his wife’s death. He cannot enjoy time with his grandchildren and reluctantly admits to thinking he has seen his dead wife in line at the supermarket or standing in the kitchen making dinner.Normal bereavement, Adjustment disorder with depressed mood, Major depressive disorder with psychotic features- Schizoaffective disorder -Depressive disorder not otherwise specified (NOS)
42 yo F presents with a four-week history of excessive fatigue, insomnia, and anhedonia. She states that she thinks constantly about death. She has suffered five similar episodes in the past, the first in her 20s, and has made two previous suicide attempts. She further admits to increased alcohol use in the past month.Major depressive disorder -Substance-induced mood disorder- Dysthymic disorder
26 yo F presents with a 3-kg weight loss over the past two months, accompanied by early-morning awakening, excessive guilt, and psychomotor retardation. She does not identify a trigger for the depressive episode but reports several weeks of increased energy, sexual promiscuity, irresponsible spending, and racing thoughts approximately six months before her presentation.Bipolar I disorder- Bipolar II disorder- Cyclothymic disorder- Major depressive disorder- Schizoaffective disorder
19 yo M c/o receiving messages from his television set. He reports that he did not have many friends in high school. In college, he started to suspect his roommate of bugging the phone. In the same time frame, he stopped going to classes because he felt that his professors were saying horrible things about him that no one else noticed. He rarely showered or left his room and has recently been hearing a voice from his television set telling him to “guard against the evil empire.”Schizophrenia- Schizoid or schizotypal personality disorder- Schizophreniform disorder- Psychotic disorder due to a general medical condition -Substance-induced psychosis -Depression with psychotic features
8 yo F c/o seeing bugs crawling on her bed over the past two days and reports hearing loud voices when she is alone in her room. She has never experienced symptoms such as these in the past. She recently ingested an unknown substance.Substance-induced psychosis -Brief psychotic disorder- Schizophreniform disorder- Schizophrenia Psychotic disorder due to a general medical condition
48 yo F presents with a one-week history of auditory hallucinations, stating, “I am worthless” and “I should kill myself.” She also reports a two-week history of weight loss, early-morning awakening, decreased motivation, and overwhelming feelings of guilt.Schizoaffective disorder- Mood disorder with psychotic features- Schizophrenia -Schizophreniform disorder -Psychotic disorder due to a general medical condition