EMQs in Clinical Medicine.pdf - Peshawar Medical College

86 Neurology
40 Treatment of headache
A
B
C
D
E
F
G
amitriptyline
morphine
timolol
paracetamol
prednisolone
evacuation via burr hole
propranolol
H
I
J
K
L
M
high-dose aspirin and
metoclopramide
pethidine
acetazolamide
carbamazepine
sumatriptan
hydrocortisone
For each clinical scenario below, suggest the most appropriate treatment for the
headache. Each option may be used only once.
1 A 52-year-old man with ischaemic heart disease requires treatment for an acute
migraine attack that has not responded to paracetamol.
2 A 75 year old has a headache and painful red congested eye with a dilated
non-responsive pupil.
3 A 65-year-old woman presents with a headache that has lasted a few weeks.
She gets pain in her mouth during meals and her scalp is tender on palpation.
4 A 70-year-old woman requiring treatment for troubling trigeminal neuralgia.
5 A 29-year-old man with a skull fracture is suffering from very severe pain
overlying the laceration to his head. He has been admitted for overnight
observation.
Answers: see page 103.