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Author Question: On a history and physical examination of a 34-year-old patient, during the review of systems, he ... (Read 148 times)

renzo156

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On a history and physical examination of a 34-year-old patient, during the review of systems, he reports occasional episodes of headache. He describes the headache pain as a band is around his head and tightness in the neck and shoulders.
 
  The clinician should recognize these symptoms as:
  A. Tension headache
  B. Cluster headache
  C. Sinusitis
  D. Migraine headache

Question 2

Mnire's 'disease presents with the following triad of symptoms:
 
  A. Vertigo, nystagmus, hearing loss
  B. Vertigo, tinnitus, hearing loss
  C. Vertigo, syncope, hearing loss
  D. None of the above



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owenfalvey

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Answer to Question 1

ANS: A
Typical symptoms of tension headache include mild to moderate nonthrobbing pressure, or squeezing pain, that can occur anywhere in the head or neck. The pain often starts slowly as a dull and aching discomfort that progresses to holocranial pain and pressure. The pain can recur intermittently, lasting from minutes to hours, usually remitting with rest or removal of the stressful trigger. There is usually no associated nausea and vomiting. Although patients may report photophobia and phonophobia, it is less severe than those associated with migraines. Tension headaches are not aggravated by movement or activity. The neck muscles are often tight to palpation.

Answer to Question 2

ANS: B
The exact cause of Mnire's disease is unknown. However, the symptoms are associated with increased fluid and pressure in the labyrinth. Mnire's disease commonly involves a triad of symptoms: severe vertigo, tinnitus, and hearing loss. The vertigo is transient but recurrent. The tinnitus and hearing loss may also be intermittent and/or recurrent but often become worse over time. A sensation of ear fullness may precede an episode. During the episode, vertigo is often debilitating and is associated with nausea and vomiting. The tinnitus and hearing loss are usually unilateral.





 

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