A 25-Year-Old Woman, Gravida 1 Para 0, at 29 Weeks

question 19

Multiple Choice

A 25-year-old woman, gravida 1 para 0, at 29 weeks gestation comes to the emergency department due to a headache.  The patient has a history of migraines but has not had one during the pregnancy until today.  She has no other chronic medical conditions.  This morning, the patient woke with a left-sided frontal headache and blurry vision in the left eye.  She took a dose of acetaminophen, but the headache did not improve and now is in the bilateral frontal region.  The patient has no sick contacts but has had increased stress at work and is working longer hours.  Her caffeine consumption has increased to 2-3 cups of coffee a day.  Blood pressure is 156/92 mm Hg and pulse is 84/min.  Fetal heart rate is 155/min.  Repeat blood pressure a few hours later is 150/94 mm Hg.  Cranial nerves are intact.  There is no nuchal rigidity.  The abdomen is soft, gravid, and nontender.  Deep tendon reflexes are normal.  The remainder of the examination is unremarkable.  Which of the following is the most likely diagnosis in this patient?

• A)Caffeine side effect
• B)Cluster headache
• C)Migraine with aura
• D)Preeclampsia
• E)Tension-type headache

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Definitions:

Malthusian Theory Of Population

Population tends to grow in a geometric progression (1, 2, 4, 8, 16), while food production tends to grow in an arithmetic progression (1, 2, 3, 4, 5).

Health Care System

The organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations.

Top Ten Countries

A term often used in rankings to refer to the ten best-performing countries in a particular category, such as economy, education, or healthcare.

Universal Health Care

A health care system that provides medical services to all residents within a given country, typically funded through the government.