USMLE Forum Archives - USMLE Step 2 CK - int med : headache
int med : headache
bingousmle - 05-10-09 08:58 Bookmark and Share

30 years male comes to the ER and complains of severe episodic headache, especially at night, for the past month. He also complains of unilateral, sharp, stabbing pain in the eye, which wakes him from sleep. It is not associated with nausea or visual disturbances, but is associated with watering of the eyes and nose, and with red eye. He had a similar episode one year ago, and it lasted for 2 months. what is the treatment for this acute attack?






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#1
Re: int med : headache
harry206 - 05-10-09 09:10

My answer is: a.

#2
Re: int med : headache
usmlefever3 - 05-10-09 10:17

My answer is: b.

#3
Re: int med : headache
meduploader - 05-11-09 12:52

My answer is: a.


its cluster headache.
male to female ration 5: 1
ssociated with watering of the eyes and nose
He had a similar episode one year ago, and it lasted for 2 months --> cluster repeat in years after in same season

#4
Re: int med : headache
usmlefever3 - 05-12-09 01:52

plz give explanation of the above question

#5
Re: int med : headache
harry206 - 05-12-09 02:33

Yes this is case of cluster Headache:
- male
- headache, especially at night
- unilateral, sharp, stabbing pain in the eye, which wakes him from sleep.
- not associated with nausea or visual disturbances
- associated with watering of the eyes and nose red eye (Ipsilateral Autonomic symptoms)
- similar episode one year ago, and it lasted for 2 months

Treatment for this acute attack: 100% O2 5-10 ml/min for 10-15 min

#6
Re: int med : headache
usmlefever3 - 05-12-09 03:23

thanks for explanation harry
i think sumatriptan is given after 100% oxygen therapy in acute attacks of cluster headache

#7
Re: int med : headache
sackatdoc - 05-14-09 21:14

My answer is: a.

#8
Re: int med : headache
harry206 - 05-15-09 05:30

posted by usmlefever3 on 05-12-09 03:23

thanks for explanation harry
i think sumatriptan is given after 100% oxygen therapy in acute attacks of cluster headache



Hi usmlefever,
100% oxygen is first line treatment for Cluster headache, and
sumatriptan is first line for Migraine headache.

GL

#9
Re: int med : headache
zkadhem - 05-19-09 20:18

My answer is: a.


Typical description of cluster headache.

#10
Re: int med : headache
drhumaira - 05-19-09 22:15

My answer is: a.

#11
Re: int med : headache
InSitu - 05-20-09 02:32

My answer is: a.

#12
Re: int med : headache
84ahsan - 05-20-09 15:27

My answer is: a.

#13
Re: int med : headache
jamesbond - 05-21-09 07:03

My answer is: a.

#14
Re: int med : headache
docbul - 05-25-09 13:33

My answer is: a.

#15
Re: int med : headache
poluashok - 05-25-09 16:35

My answer is: a.

#16
Re: int med : headache
angella - 05-26-09 09:26

My answer is: a.

#17
Re: int med : headache
fas148 - 05-27-09 03:55

My answer is: a.

#18
Re: int med : headache
shahprasun - 06-02-09 13:57

My answer is: a.

#19
Re: int med : headache
shujayat - 06-08-09 01:40

My answer is: c.

#20
Re: int med : headache
omojesu - 06-12-09 01:59

My answer is: a.

#21
Re: int med : headache
docraj - 06-13-09 18:54

My answer is: a.

#22
Re: int med : headache
Youngdoctor - 06-13-09 21:58

My answer is: b.

#23
Re: int med : headache
Youngdoctor - 06-13-09 21:59

what is the diagnosis?.

#24
Re: int med : headache
caraga - 06-14-09 09:34

My answer is: a.

#25
Re: int med : headache
crazyserb - 06-15-09 01:35

My answer is: a.

#26
Re: int med : headache
petitbebe - 06-15-09 04:22

My answer is: b.

#27
Re: int med : headache
samer06 - 06-15-09 13:18

My answer is: a.

#28
Re: int med : headache
samer06 - 06-15-09 13:19

dx is cluster headache

#29
Re: int med : headache
conym5 - 06-17-09 01:31

My answer is: a.

#30
Re: int med : headache
heyamawad - 06-17-09 06:20

My answer is: e.

#31
Re: int med : headache
reksarma - 09-29-09 11:55

My answer is: c.

#32
Re: int med : headache
mtniharika - 09-29-09 13:12

My answer is: c.

#33
Re: int med : headache
amaniagz - 10-02-09 13:45

My answer is: a.

#34
Re: int med : headache
omegamed - 10-02-09 14:14

My answer is: a.

#35
Re: int med : headache
haward - 10-02-09 17:46

My answer is: a.

#36
Re: int med : headache
bonkee - 10-04-09 11:29

My answer is: a.

#37
Re: int med : headache
ajitelaprolu - 10-09-09 05:09

My answer is: c.

#38
Re: int med : headache
ysemak - 10-22-09 12:13

My answer is: a.

#39
Re: int med : headache
ramarao - 10-26-09 22:33

My answer is: c.

#40
Re: int med : headache
aetmike - 10-27-09 01:36

My answer is: c.

#41
Re: int med : headache
drdinz - 10-27-09 22:02

My answer is: d.

#42
Re: int med : headache
dnaderadam - 10-30-09 09:51

My answer is: a.


cluster headache

#43
Re: int med : headache
alaamn - 10-31-09 07:53

My answer is: a.

#44
Re: int med : headache
hanan2009el - 11-01-09 01:05

My answer is: b.

#45
Re: int med : headache
rababzain - 11-03-09 07:06

My answer is: a.

#46
Re: int med : headache
vernette - 11-05-09 23:41

My answer is: a.

#47
Re: int med : headache
dadukids - 12-07-09 22:43

My answer is: a.

#48
Re: int med : headache
noonysafi - 12-08-09 07:55

My answer is: a.

#49
Re: int med : headache
tianjin - 12-08-09 21:31

My answer is: b.

#50
Re: int med : headache
bhogisantosh143 - 12-10-09 07:42

My answer is: a.

#51
Re: int med : headache
jordanrobin - 12-10-09 08:29

My answer is: b.

#52
Re: int med : headache
eugenio - 12-12-09 10:04

My answer is: b.

#53
Re: int med : headache
medusmle01 - 12-16-09 01:29

My answer is: a.

#54
Re: int med : headache
badrh4sse5n - 12-17-09 17:17

My answer is: a.

#55
Re: int med : headache
masroor - 12-20-09 12:55

My answer is: a.


patient has cluster headache

#56
Re: int med : headache
nidayasir - 12-20-09 14:10

My answer is: d.

#57
Re: int med : headache
demolition - 12-21-09 10:20

My answer is: a.

#58
Re: int med : headache
grantyh - 12-22-09 20:31

My answer is: a.

#59
Re: int med : headache
oldman - 01-11-10 06:56

My answer is: a.

#60
Re: int med : headache
tahiraraees - 02-08-10 15:02

My answer is: e.

#61
Re: int med : headache
shahra - 02-21-10 03:02

My answer is: b.

#62
Re: int med : headache
eld2010 - 02-21-10 11:36

My answer is: d.

#63
Re: int med : headache
medic - 02-22-10 05:35

My answer is: c.

#64
Re: int med : headache
leminesow - 02-22-10 08:18

My answer is: d.

#65
Re: int med : headache
robaid - 02-24-10 10:09

My answer is: c.

#66
Re: int med : headache
gkhurram - 02-25-10 22:48

My answer is: b.

#67
Re: int med : headache
hind708 - 03-02-10 13:14

My answer is: b.

#68
Re: int med : headache
dreguieg - 03-02-10 20:48

My answer is: d.

#69
Re: int med : headache
navid1352 - 03-03-10 02:18

My answer is: b.

#70
Re: int med : headache
ammulufy - 03-14-10 10:24

My answer is: b.


I am confused with d answer between cluster headache or migraine but because it is not associated with nausea or visual disturbances its favouring cluster headache.....hence the answer is ergotamine.

#71
Re: int med : headache
ammulufy - 03-14-10 10:27

I am still confused becos first of all 100%O2 or Sumatriptan r d medications for Migraine but d answer according to me was cluster headache bcos of whch i chose ergotamine....please culd enlighten me with d diagnosis n y sumatriptan is not d answer if migraine is d diagnosis.

#72
Re: int med : headache
residencyrace - 05-30-10 10:13

My answer is: c.

#73
Re: int med : headache
bolajipoland98 - 06-01-10 01:33

My answer is: a.

#74
Re: int med : headache
samyou - 06-02-10 16:34

My answer is: a.

#75
Re: int med : headache
victoria12 - 06-03-10 09:07

My answer is: b.

#76
Re: int med : headache
bingousmle - 06-07-10 07:29

posted by ammulufy on 03-14-10 10:27

I am still confused becos first of all 100%O2 or Sumatriptan r d medications for Migraine but d answer according to me was cluster headache bcos of whch i chose ergotamine....please culd enlighten me with d diagnosis n y sumatriptan is not d answer if migraine is d diagnosis.



this is a case of cluster headache ann not migraine... this is one of the classical case scenarios for cluster headache.. so the treatment is 100percent oxygen

#77
Re: int med : headache
babbu5508 - 06-07-10 13:44

My answer is: a.


the description well suited for a cluster headache..headache unilateral with retroorbital pain and watering of eyes and nose..Rx..100% o2

#78
Re: int med : headache
bingousmle - 06-07-10 14:05

My answer is: a.

#79
Re: int med : headache
lihuazou - 06-07-10 14:25

My answer is: a.

#80
Re: int med : headache
usmlerose - 06-08-10 09:30

My answer is: b.

#81
Re: int med : headache
brandymandy - 06-08-10 09:35

My answer is: d.

#82
Re: int med : headache
dryogi - 06-10-10 03:54

My answer is: a.

#83
Re: int med : headache
zubiashoaib - 06-10-10 19:52

My answer is: a.

#84
Re: int med : headache
drsvham27 - 06-10-10 21:58

My answer is: d.

#85
Re: int med : headache
drmonia57 - 09-20-11 15:12

My answer is: e.

#86
Re: int med : headache
chowdhury84 - 12-23-11 21:59

My answer is: a.

#87
Re: int med : headache
shaiza - 04-01-12 21:14

My answer is: a.

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