Headaches on Step 1 - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-08-2016
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 2
Threads: 1
Thanked 0 Times in 0 Posts
Reputation: 10
Default Headaches on Step 1

Hello,

I am yet to find a comprehensive source for all the high-yield sources of headaches and how to distinguish between them. I am hoping this thread can become that source. I will make an initial list and would love it if people could add details. I'm hoping in a week or so, this list can be complete!



Causes

Acute Closure Glaucoma
Periorbital, frontal pain. Pupil dilated and non-reactive to light. Vision loss, halo's around light.
Can be caused by atropine (Muscarinic antagonist)
Can be treated with pilocarpine (Muscarinic agonist), acetazolamide, mannitol, beta blockers

Cluster
Unilateral, male, brief and episodic pain, periorbital pain, lacrimation and rhinorrhea. May induce Horner's.

Acute Tx: 100% O2, sumatriptan (note: sumatriptan is contraindicated with CAD, HTN, and pregnancy)
Chronic Tx: Verapamil, lithium, ergot

I feel like Cluster HA and acute closure glaucoma will be challenge to distinguish.


Tension
Bilateral, stress and depression, steady pain.

Acute Tx: NSAIDS
Chronic Tx: Amytriptyline, propranalol

Migraine
Unilateral, female, pulsating pain, photo/phonophobia, "aura" is present.

Acute Tx: Dark and quiet environment, sumatriptan, NSAIDS
Chronic Tx: Amytriptyline, propranalol, verapamil, topiramate

Temporal Artritis
Temporal region, women over 50, elevated ESR, Jaw Claudication
Often occurs in conjunction with polymyalgia rheumatica (pain and stiffness in shoulders, fever, no weakness)

Tx for both TA and PR: corticosteroids

This one should be easy to pin-point.


Benign/idiopathic intracranial hypertension (pseudotumor cerebri)
Increased intracranial pressure, papilledema and vision loss can result
Cause: too much Vit A (acutane)
Tx: stop Vit A source, acetazolamide

Communicating Hydrocephalus
Increased intracranial pressure, papilledema and vision loss can result

Tx: VP shunt and vancomyocin

I have not idea how to distinguish Comm Hydro and pseudotumor cerebri!


Subarachnoid hemorrhage
"Worst headache of my life", nuchal rigidity may be present

Meningitis
Fever, nuchal rigidity, altered mental status may be present, photophobia if viral etiology

Is fever and the magnitude of the pain the only way to distinguish between meningitis and SA hemorrhage?


Neoplasia
Weight loss?

Trigeminal Neuralgia

Easy to diagnose because this is really not a headache. It is a sharp, burning facial pain. Note: it is associated with MS.
Reply With Quote Quick reply to this message



  #2  
Old 05-08-2016
USMLE Forums Newbie
 
Steps History: Not yet
Posts: 2
Threads: 1
Thanked 0 Times in 0 Posts
Reputation: 10
Default Summary of questions

How to distinguish between:


1) Pseudotumor cerebri and communicating hydrocephalus

2) Meningitis and SA Hemorrhage

3) Cluster HA and Acute closure glaucoma

4) Is my list missing anything major?

Thanks!
Reply With Quote Quick reply to this message
  #3  
Old 05-11-2016
USMLE Forums Scout
 
Steps History: 1+CK+CS
Posts: 35
Threads: 1
Thanked 3 Times in 1 Post
Reputation: 13
Default

acute angle closure glaucoma has a red eye

SAH has blood on LP
Reply With Quote Quick reply to this message



Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Treatment of Headaches heartbeat USMLE Step 2 CK Forum 4 12-15-2012 07:25 AM
Monday Headaches and Dizziness MedicalExaminer USMLE Step 1 Forum 19 11-02-2012 10:47 AM
Easy way to remember Headaches jopaa USMLE Step 1 Forum 0 02-28-2012 10:49 PM
Headaches while preparing for USMLE step_enhancer General Topics Forum 15 01-28-2012 03:15 AM
Cluster headaches aksyonez USMLE Step 2 CK Forum 3 06-21-2011 08:14 AM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)