Differential Diagnosis of Headache Essay
Differential Diagnosis of Headache Essay
The patient, Loretta A. is a 44-year-old Hispanic Female. She exhibits a severe right sided head pain for the last 24 hours. She denies fever within this time period or any head trauma. Owing to this fact, the following is a differential diagnosis of the patient’s headaches.
Owing to the information obtained from the patient, the patient may be suffering from cluster headaches or migraines. This is owing to the fact that the pain she experiences are severe. Furthermore the pain has been on-going for the past 24 hours. This indicated either cluster headaches or migraines. Differential Diagnosis of Headache Essay.
Works Cited
Bruijn, G. W. (1969). Handbook of clinical neurology: Edited by P.J. Vinken and G.W. Bruyn. Amsterdam: North-Holland Pub. Co.
Dains, J. B. (2012). Advanced health assessment and clinical diagnosis in primary (4th ed.). St. Louis: Elsevier Mosby.
Olesen, J., Goadsby, P. J., & Ramadan, N. M. (2006). The Headaches. Philadelphia: Lippincott Williams & Wilkins.
Pathophysiology
The pathophysiology of cluster headache is complex and cannot be identified precisely; however, the most popular theories describe such states as abnormal functioning of hypothalamus, vascular dilation, circadian effects, trigeminal nerve stimulation, and histamine release that may bring about unilateral temporal and periorbital pain that continues up to 2 hours (Dunphy, Winland-Brown, Porter, & Thomas, 2015).
Symptoms and Signs
Pain on one side of the head (burning, sharp or steady), pain around one eye, red or swollen eyes, tearing, rhinorrhea or stuffy nose, burning face. Differential Diagnosis of Headache Essay.
Lab and Diagnostic Tests
Neurological examination is required to assess brain function, reflexes, and senses. In complicated cases, CT scan (using X-rays to make cross-sectional pictures of the brain) and MRI may be recommended (Dunphy et al., 2015).
References
Adnot, S. (2014). Cell senescence and pathophysiology of chronic lung diseases: Role in chronic obstructive pulmonary disease. Bulletin de l’Academie nationale de medecine, 198(4-5), 659-671.
Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care: The art and science of advanced practice nursing. Philadelphia, PA: F.A. Davis Company.
Gould, B. E., VanMeter, K. C., & Hubert, R. J. (2014). Pathophysiology for the health professions. St. Louis, MO: Elsevier Saunders.
Hollier, A. (2016). Clinical guidelines in primary care (2d ed.). Scott, LA: APEA. Differential Diagnosis of Headache Essay.
When you seek attention for a medical concern, your doctor uses the diagnostic process to determine the condition that may be causing your symptoms.
As part of this process, they’ll review items such as:
- your current symptoms
- medical history
- results from a physical examination
A differential diagnosis is a list of possible conditions or diseases that could be causing your symptoms based off of this information.
When performing a differential diagnosis, your doctor will first collect some initial information regarding your symptoms and medical history.
Some example questions your doctor may ask include:
- What’re your symptoms?
- How long you have been experiencing these symptoms?
- Is there anything that triggers your symptoms?
- Is there anything that makes your symptoms worse or better?
- Do you have a family history of specific symptoms, conditions, or diseases?
- Are you currently taking any prescription medications?
- Do you use tobacco or alcohol? If so, how frequently?
- Have there been any major events or stressors in your life recently?
Your doctor may then perform some basic physical or laboratory examinations. Differential Diagnosis of Headache Essay. Some examples include, but are not limited to:
- taking your blood pressure
- monitoring your heart rate
- listening to your lungs as you breathe
- examining the part of your body that’s bothering you
- ordering basic laboratory blood or urine tests
When they’ve gathered the relevant facts from your symptoms, medical history, and physical examination, your doctor will make a list of the most likely conditions or diseases that may be causing your symptoms. This is the differential diagnosis.
Your doctor may then perform additional tests or assessments to rule out specific conditions or diseases and reach a final diagnosis.
Here are some simplified examples of what a differential diagnosis may look like for some common conditions.Differential Diagnosis of Headache Essay.
Chest pain
John visits his doctor complaining of pain in his chest.
Since a heart attack is a common cause of chest pain, his doctor’s first priority is to make sure that John is not experiencing one. Other common causes of chest pain include pain in the chest wall, gastroesophageal reflux disease (GERD), and pericarditis.
The doctor performs an electrocardiogram to evaluate the electrical impulses of John’s heart. They also order blood tests to check for certain enzymes that’re associated with a heart attack. The results from these assessments are normal.
John tells his doctor that his pain feels like a burning sensation. It typically comes shortly after having a meal. In addition to his chest pain, he sometimes has a sour taste in his mouth.
From the description of his symptoms as well as the normal test results, John’s doctor suspects that John may have GERD. The doctor prescribes John a course of proton pump inhibitors that eventually relieves his symptoms. Differential Diagnosis of Headache Essay.
Headache
Sue goes to see her doctor because she’s having a persistent headache.
In addition to performing a basic physical examination, Sue’s doctor asks about her symptoms. Sue shares that the pain from her headaches is moderate to severe. She sometimes feels nausea and sensitivity to light while they’re occurring.
From the information provided, Sue’s doctor suspects that the most likely conditions could be migraines, tension headaches, or possibly a post-traumatic headache.
The doctor asks a follow-up question: Have you experienced any sort of head injury recently? Sue responds that yes, she had fallen and hit her head a little over a week ago.
With this new information, Sue’s doctor now suspects a post-traumatic headache.Differential Diagnosis of Headache Essay. The doctor may prescribe pain inhibitors or anti-inflammatory medications for her condition. In addition, the doctor may perform imaging tests such as an MRI or CT scan to rule out bleeding in the brain or a tumor.
Pneumonia
Ali visits his doctor with symptoms of pneumonia: fever, cough, chills, and pains in his chest.
Ali’s doctor performs a physical exam, including listening to his lungs with a stethoscope. They perform a chest X-ray to view his lungs and confirm pneumonia.
Pneumonia has different causes — particularly if it’s bacterial or viral. This can affect treatment.
Ali’s doctor takes a mucus sample to test for the presence of bacteria. It comes back positive, so the doctor prescribes a course of antibiotics to treat the infection.
Hypertension
Raquel is at her doctor’s office for a routine physical. When her doctor takes her blood pressure, the reading is high.
Common causes of hypertension include certain medications, kidney disease, obstructive sleep apnea, and thyroid problems. Differential Diagnosis of Headache Essay.
High blood pressure doesn’t run in Raquel’s family, although her mother had thyroid problems. Raquel doesn’t use tobacco products and uses alcohol responsibly. Additionally, she’s not currently taking any medications that could lead to high blood pressure.
Raquel’s doctor then asks if she’s noticed anything else that seems out of the ordinary with her health lately. She replies that she feels as if she’s been losing weight and that she often feels hot or sweaty.
The doctor performs laboratory tests to assess kidney and thyroid function.
The kidney test results are normal, but Raquel’s thyroid results indicate hyperthyroidism. Raquel and her doctor begin to discuss treatment options for her overactive thyroid.
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Stroke
A family member takes Clarence to receive immediate medical attention because they suspect he’s having a stroke.
Clarence’s symptoms include headache, confusion, loss of coordination, and impaired vision. The family member also lets the doctor know that one of Clarence’s parents had a stroke in the past and that Clarence smokes cigarettes frequently. Differential Diagnosis of Headache Essay.
From the symptoms and history provided, the doctor strongly suspects a stroke, although low blood glucose can also cause symptoms similar to a stroke.
They perform an echocardiogram to check for an abnormal rhythm that could lead to clots, which could travel to the brain. They also order a CT scan to check for brain hemorrhaging or tissue death. Lastly, they perform blood tests to see the speed at which Clarence’s blood clots and to assess his blood glucose levels.
The CT scan indicates a hemorrhage in the brain, confirming that Clarence has had a hemorrhagic stroke.
Since a stroke is a medical emergency, the doctor may begin emergency treatment before all test results are obtained.
A differential diagnosis is a list of possible conditions or diseases that could be causing your symptoms. It’s based off of the facts obtained from your symptoms, medical history, basic laboratory results, and a physical examination.
After developing a differential diagnosis, your doctor may then perform additional tests to begin to rule out specific conditions or diseases and come to a final diagnosis. Differential Diagnosis of Headache Essay.
