Headaches: Clinical (To be retired)

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Headaches: Clinical (To be retired)

Medicine and surgery

Allergy and immunology

Antihistamines for allergies

Glucocorticoids

Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications

Insulins

Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Osteoporosis medications

Assessments

Headaches: Clinical (To be retired)

USMLE® Step 2 questions

0 / 21 complete

Questions

USMLE® Step 2 style questions USMLE

of complete

A 20-year-old woman comes to the clinic due to debilitating headaches for the past two months. She recently started college, and has been under a lot of stress due to the amount of work. Her medical history is significant for generalized anxiety disorder. She rates the pain as a 5 on a 10-point scale, and describes it as “tightness around her head”. Physical examination shows tenderness over the trapezius muscles bilaterally. Which of the following is most likely to benefit this patient in the long term?  

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Evan Debevec-McKenney

Tanner Marshall, MS

We’ve all had them. Headaches can be debilitating, and they occur when any of the pain-sensitive structures in the head and neck are stimulated. These include the meninges, blood vessels, nerves, and muscles.

Headaches can be classified into primary and secondary headaches. Primary headaches include tension, migraine, and cluster headaches, whereas secondary headaches are those that are due to another underlying disorder.

When an individual has a headache, especially if it feels different from their usual headaches, it’s important to think through causes of secondary headaches to avoid missing something important or life-threatening.

The mnemonic “SNOOP”, without the “D-O-double G”, summarizes some of the red flags.

“S” is for systemic symptoms like fever or weight loss.

“N” is for neurological symptoms, like weakness, sensory deficits, or vision loss.

The first “O” is for a new or sudden onset headache.

The second “O” is for other associated conditions, like trauma.

The “P” stands for progression or pattern, such as a headache that is worsening in severity or frequency.

Any of these findings warrant further investigation like brain imaging with a CT scan, or MRI, and in some cases a lumbar puncture.

Some clinical features may point towards a specific diagnosis, some of which may be life-threatening!

For example, if the headache develops suddenly, and feels like a 10 out of 10 in terms of pain right at its onset, or if it’s called “the worst headache of my life”, then it might be a subarachnoid hemorrhage. And it’s typically caused by rupture of an intracranial aneurysm.

Now, if someone has a sudden headache after a trauma, and it radiates down one side of the neck and is associated with Horner syndrome then it could be due to a carotid or vertebral artery dissection. This is also associated with pulsatile tinnitus which is a pulsating ringing sensation in the ears. If left untreated, the dissection could extend into the intracranial vessels, leading to a stroke.

Elsevier

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