Test your medicine knowledge: 28-year-old man with recurrent headaches

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated for a 5-year history of recurrent headache that occurs several times per month and lasts 12 to 24 hours. He describes the headache as a bilateral frontal pressure associated with nasal congestion and sensitivity to light, sound, and smell. The pain is generally moderate in intensity but worsens when he bends forward or exercises and has caused him to miss 3 days of work recently. He has no nausea or visual or neurologic symptoms. The patient has a history of nonseasonal allergic rhinitis treated with pseudoephedrine and loratadine and a family history of headaches in his paternal grandmother. His only other medication is naproxen, which he takes as needed for the headache pain but has become less effective over time. Physical examination findings, including vital signs and results of neurologic examination, are normal. Which of the following is the most appropriate management of this patient’s disorder? A: CT scan of the sinuses B: MRI of the brain C: Nasal corticosteroids D: Oxycodone E: Sumatriptan Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Neurology Source Type: blogs