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Exam (elaborations)

USMLE Step 2 CS Minicases ALL

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USMLE Step 2 CS Minicases ALL HEADACHE Key History ️️*Onset*: acute vs. chronic *Location*: u/l vs. b/l *Quality*: dull, stabbing *Intensity*: worst HOL? *Duration* *Timing*: disturb sleep? *Neuro sx*: paresthesias, visual changes, weakness, ataxia, photophobia, dizziness, auras...

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  • November 14, 2024
  • 123
  • 2024/2025
  • Exam (elaborations)
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  • USMLE Step 2 CS Minicases ALL
  • USMLE Step 2 CS Minicases ALL
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USMLE Step 2 CS Minicases ALL

HEADACHE



Key History ✔️✔️*Onset*: acute vs. chronic

*Location*: u/l vs. b/l

*Quality*: dull, stabbing

*Intensity*: worst HOL?

*Duration*

*Timing*: disturb sleep?

*Neuro sx*: paresthesias, visual changes, weakness, ataxia, photophobia, dizziness, auras, neck stiffness

*Other sx*: N/V, jaw claudication, recent trauma, dental surgery, sinusitis sx

*Exacerbating/alleviating factors*

*Patient hx

Family hx*



HEADACHE



Physical Exam ✔️✔️Vital signs

Inspection and palpation of head

ENT inspection

Neuro exam

Fundoscopic exam



26 yo M presents with severe right

temporal headaches associated with

ipsilateral rhinorrhea, eye tearing, and

redness. Episodes have occurred at the

,same time every night for the past week

and last for 45 minutes. ✔️✔️*Cluster headache*

Migraine

Tension headache

Sinusitis

Pseudotumor cerebri

Trigeminal neuralgia

Intracranial neoplasm



CBC

ESR

CT—head

MRI—brain

LP



21 yo F presents with several episodes of

throbbing left temporal pain that lasts

for 2-3 hours. Prior to its onset, she sees

fl ashes of light in her right visual fi eld

and feels weakness and numbness on the

right side of her body for a few minutes.

Headaches are often associated with

nausea and vomiting. She has a family

history of migraine. ✔️✔️*Migraine (complicated)*

Tension headache

Cluster headache

Pseudotumor cerebri

Trigeminal neuralgia

CNS vasculitis

,Partial seizure

Intracranial neoplasm



CBC

ESR

CT—head

MRI—brain

LP



65 yo F presents with severe, intermittent

right temporal headache, fever, blurred

vision in her right eye, and pain in her

jaw when chewing. ✔️✔️*Temporal arteritis (giant cell arteritis)*

Migraine

Cluster headache

Tension headache

Meningitis

Carotid artery dissection

Pseudotumor cerebri

Trigeminal neuralgia

Intracranial neoplasm



CBC

ESR

CRP

Temporal artery biopsy

Doppler U/S—carotid

MRI—brain

, 30 yo F presents with frontal headache,

fever, and nasal discharge. There is pain

on palpation of the frontal and maxillary

sinuses. She has a history of sinusitis. ✔️✔️*Sinusitis*

Migraine

Tension headache

Meningitis

Intracranial neoplasm



CBC

XR—sinus

CT—sinus

LP



50 yo F presents with recurrent episodes

of bilateral squeezing headaches that

occur 3-4 times a week, typically

toward the end of her work day. She is

experiencing signifi cant stress in her life. ✔️✔️*Tension headache*

Migraine

Depression

Caffeine or analgesic withdrawal

Hypertension

Cluster headache

Pseudotumor cerebri

Intracranial neoplasm



CBC

Electrolytes

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