The Patient Is A 24-Year-Old Female Administrative Assistant

Question

The Patient Is A 24 Year Old Female Administrative Assistant Who Comes The patient is a 24-year-old female administrative assistant who presents to the emergency department with a chief complaint of severe right-sided headache. She reports that this is the sixth episode of such headaches in the past two months. Each headache lasts between two to three days and has increasingly affected her ability to concentrate at work. She also notes associated symptoms of nausea and has vomited three times in the last three hours. She describes her pain as a 10 out of 10 on the pain scale. She reports that over-the-counter medications like ibuprofen and acetaminophen provide some relief but do not completely alleviate her symptoms. No other current complaints are noted.

Dr. Jack HW Helper · Accepted Answer

Introduction Headaches are a common neurological complaint encountered in emergency medicine. When assessing a patient with recurrent severe headaches, particularly those associated with nausea, vomiting, and photophobia, it is imperative to consider a broad differential diagnosis. This case involves a young woman presenting with episodic, severe unilateral headaches, prompting a systematic approach to diagnosis and management. Clinical Presentation and Initial Assessment The patient’s presentation of multiple recent episodes of severe right-sided headache, lasting several days, accompanied by nausea, vomiting, and photophobia, is suggestive of a primary or secondary headache disorder. Her report of worsening concentration indicates significant symptom impact. An immediate assessment should focus on vital signs, neurological examination, and possible signs of increased intracranial pressure or focal deficits. Diagnostic Considerations Initial differential diagnoses include migraines, cluster headaches, tension-type headaches, and secondary causes such as intracranial pathology (e.g., tumor, aneurysm, or hemorrhage). The episodic nature and unilateral pain favor migraine or cluster headache, but secondary causes must be ruled out through appropriate investigations. Important Features and Red Flags Red flags include the acute worsening of headache severity, new neurological deficits, altered mental state, or signs of increased intracranial pressure. The patient’s pattern of recurrent severe headaches with associated nausea and photophobia aligns with migraines; however, the intensity and frequency necessitate imaging to exclude secondary causes. Management Strategies Immediate management involves symptomatic relief using analgesics, antiemetics, and possibly triptans for migraine attacks if appropriate. Preventive strategies might include lifestyle modifications and prophylactic medications. For recurrent severe headaches, a neurologist’s consultation and neuroimaging

The Patient Is A 24-Year-Old Female Administrative Assistant ✓ Solved

The Patient Is A 24 Year Old Female Administrative Assistant Who Comes

Sample Paper For Above instruction

Introduction

Clinical Presentation and Initial Assessment

Diagnostic Considerations

Important Features and Red Flags

Management Strategies

Long-term Considerations

Conclusion

References