A 34-Year-Old Man Comes to the Emergency Department Due to Severe

question 338

Multiple Choice

A 34-year-old man comes to the emergency department due to severe headache.  The patient describes unbearable, throbbing pain around his right eye that awakened him.  Over the past week, he has had several similar episodes, which spontaneously resolved after 20-30 minutes.  He has no other medical conditions and takes no medications.  The patient smokes a pack of cigarettes daily and drinks alcohol on social occasions.  On physical examination, he appears restless and paces in the room.  There is mild conjunctival injection and miosis of the right eye.  Neurologic examination shows no abnormalities.  Which of the following is the most likely cause of this patient's current symptoms?

• A)Cavernous sinus thrombosis
• B)Cluster headache
• C)Migraine without aura
• D)Opiate withdrawal
• E)Trigeminal neuralgia
• F)Vertebrobasilar ischemia

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Definitions:

Defective

Referring to a product or item that has a flaw or fault that prevents it from functioning correctly or as intended.

Lie Detector

A device or technique used to attempt to determine whether a person is telling the truth by measuring physiological responses.

Polygraph

An instrument that measures and records several physiological indicators such as blood pressure, pulse, respiration, and skin conductivity while a subject is asked questions, purported to indicate lying or truthfulness.

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