Exam 2 - Ha

Question 1

33 y/o female, with history of chronic HA, presents with unilateral, recurrent throbbing pain for the last several days that is throbbing and persistent in nature. Patient states she sees an aura 15 min prior to each HA and is contralateral to the side of the HA

Answer 1

provisional dx: Classic migraine

Question 2

Migraine with prominent aura and prodrome

Answer 2

Classic Mirgraine

Question 3

Migraine with vague or absent aura and/or prodrome

Answer 3

Common migraine (more frequent)

Question 4

30 y/o male, with no PMH, presents with severe recurrent unilateral periorbital HAs over the past month, lasting 30 min each time. patient states he gets HA early in morning

Answer 4

provisional dx: Cluster HA (more common in men)

Question 5

31 y/o female, with no PMH, presents with persistent dull HA in occipital region for last several days. pain is described as a constrictive band around the head. Pt states she has HA upon wakening but denies HA at night

Answer 5

provisional dx: Tension HA (most common)

Question 6

28 y/o female, with no PMH, presents with HA to the frontotemporal region that is throbbing and gradual in nature, for the last 36 hours.

Answer 6

provisional dx: common migraine (more common)

Question 7

66 y/o female, with PMH of HTN, presents with right eye pain and visual halos

Answer 7

provisional dx: glaucoma

Question 8

Tension HA

Answer 8

Nature of patient: more common in women and most common HA

Nature of sxs: Usually dull and nonthrobbing, with persistent low intensity that may last a few days. Severity may increase as day progresses and then decrease toward evening. Usually occipital, suboccipital, and bilateral. Described as constrictive band around head or tightness of scalp. Rarely awakens patient from sleep

Precipitating: Stress, bruxism, analgesic withdrawal

Ameliorating: stress reduction

Question 9

Recurrent HA that worsens with cough/sneeze and gets better with BB

Answer 9

vascular HA

Question 10

HA that occurs at the same time of day 1-3 times a day for 3-8 weeks and usually has an early morning onset

Answer 10

Cluster HA

Question 11

39 y/o female, with no PMH, presents with recurrent left jaw and ear pain over the past month.exam found pain to worsen when opening jaw

Answer 11

provisional dx: TMJ dysfunction