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19 Cards in this Set
- Front
- Back
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CC: HA
What PE steps? |
-vitals
-HEENT -full neuro (+ fundoscopic) |
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CC: HA
History parts you might forget? |
- photophobia
- ataxia - neck stiffness -jaw claudication - trauma -dental surgery - sinusitis - prior hx (or fam hx) of headache |
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HA in 21 yo, throbbing L temporal 2-3 hrs
visual haura at onset weakness and numbness on right side of her body for a few min prior +n/v family hx migraine Differential? Work up? |
DDx:
-complicated migraine - tension ha - cluster ha - pseudotumor cerebrei - partial seizure Work up: CBC ESR LP MRI brain |
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CC: HA in 26 yo M
severe R temporal, w/ ipsilateral rhinorrhea, eye tearing, redness SAme time every night for one week last 45 min DDx: ? Work up? |
DDx: cluster ha, migraine ha, tension ha, sinusitis, trigeminal neuralgia
work up? CBC, CT sinus, MR brain |
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HA:
65 yo F severe intermittent R temporal HA fever, blurrd vision in R eye pain in jaw with chewing DDx: Work up? |
DDx: Temporal arteritis, tension ha, migraine ha, cluster headache, carotid artery dissection
Work up: CBC, ESR, CRP, temporal artery biopsy, carotid dopler |
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HA:
30 yo F frontal HA fever nasal dischare pain w/ palpation of frontal/maxillary sinuses hx of allergies DDx: ? Work up? |
DDx: Sinusitis, meningitis, migraine, tension headache
Work up: CBC, CT sinus, LP |
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HA:
50 yo F recurrent bilateral squeezing ha (3-4 x/week) end of work day significant stress DDx:? Work up:? |
DDx: Tension HA, migraine ha, depression, analgesic withdrawal, hypertension
Work up: CBC, electrolytes, CT head, reevaluate blood pressure |
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HA:
35 yo M sudden severe headache + vomiting +confusion + L hemiplegia + nuchal rigidity DDx: Work up? |
DDx: Subarachnoid hemmorhage, complicated migraine, meningitis, intracranial hemorrhage, vertebral artery dissection
Work up: CT head (non-contrast), LP, CBC |
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HA:
25 yo M, high fever, severe ha, confusion, photophobia, nuchal rigidity + kernig + brudzinski DDx:? Work up:? |
DDx: Meningitis (bacterial vs viral), subarachnoid hemorrhage, migraine (complicated), acute sinusitis
Work up: CBC, LP (CSF analysis w/ cell count, Glucose, Protein, Culture, viral PCR), CT head (non-contrast) , CT sinus |
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HA:
18 yo obese F pulsatile ha x2-3 week + vomiting +blurred vision Meds include OCPs DDx:? Work up? |
DDx: pseudotumor cerebrei, intracranial mass, migraine ha, cluster headache, tension headache, intracranial venous thrombosis
Work up: CBC, LP (opening pressure), MRI brain, PT/PTT/INR, urine HCG |
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HA:
57 yo M daily pain R cheek for 1 mo electric stabbing occurs while shaving lasts 2-4 min DDx:? Work up? |
DDx: Trigeminal neuralgia, cluster headache, migraine headache, tension headache, intracranial mass
Work up: CBC, ESR, MRI brain |
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CC: Confusion/Memory Loss
History components? |
colateral hx from family
detailed course (acute vs chronic) associated sx- constitutional, incontinence, ataxia, hypoT, depression) Delirium? falls- subdural? meds- antichol, etc (med changes) CVA/atherosclerotic disease syphilis, HIV, alcohol |
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CC: Confusion/ Memory Loss
PE components? |
Vitals
Full Neuro- including gait MMSE General physical- heart lungs, abdomen, extremities, ENT |
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CC: Confusion/memory loss
81 yo M progressive for several years (forget, clumsy) + HTN/DM/ 2 strokes w/ L hemiparesis Step wise decline DDx: ? Work up? |
DDx: vascular dementia, alzheimers, chronic subdural hematoma, depression, hypothyroidism, B12 deficiency, neurosyphillis
Work up: CBC, TSH, B12, CT head, VDRL/RPR |
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CC: Confusion/Memory
84 yo F forgetfullness 9phone number, way back home) problems with ADLS gradual progression over years DDx? Work up? |
DDx: alzheimer's disease, vascular dementia. depression, hypoT, b12 deficiency, chronic subdural hematoma, NPH, neurosyph
Work up: CBC, B12, TSH, VDRL/RPR, MRI brain |
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CC: memory/confusion
72 yo M memory loss gait problem urinary incontinence x 6 mo DDx? Work up? |
DDx: NPH, intracranial mass, alzheimer, vascular demential, chronic subdural, hypoT, B12 deficiency
Work up: MRI brain, LP opening pressure, TSH, B12 |
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CC:confusion/memory
55 yo M rapidly progressive change in MS inability to concentrate/memory impairment x2mo myoclonus/ataxia DDx:? Work up? |
DDx: Creutzfeldt-jakob disease, intracranial mass, lewy body dementia, vascular dementia, depression, b12, hypot
Work up: MRI brain, CBC, electrolytes, TSH, B12, brain biopsy |
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CC: Confusion/Memory Loss
70 yo M insulin dependent DM episodes confusion, dizzy, palpitation, diaphoresis, weak DDx:? Work up? |
hypoglycemia, panic attack, TIA, angina, arrhythmia
Work up: basic metabolic panel (with glucose), CBC, EKG, Holter Monitor, Carotid doppler US |
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CC: Confusion/ Memory loss
55 yo F gradual altered mental status HA 2 weeks ago slipped and hit head loc x2 min ddx:? work up:? |
DDx: Chronic sudural hematoma, SIADH 2/2 trauma, intracranial neoplasm
Work up: CT head (non-contrast) MRI brain, Basic metabolic panel (sodium) |
