A 28-Year-Old Man Comes to the Office for a Health

question 255

Multiple Choice

A 28-year-old man comes to the office for a health maintenance visit.  He has no history of serious illness but reports periodic headaches over the last several years that often respond to acetaminophen.  Occasionally the headaches are severe enough to necessitate taking a sick day from work.  He cannot recall specific triggers but notes that the headaches are usually unilateral.  The patient does not use tobacco or illicit drugs.  He drinks alcohol socially and 2-3 cups of coffee daily.  He is a software engineer and often works at a computer 10-12 hours a day.  His sister has a history of migraines.  Vital signs are within normal limits.  Physical examination, including neurological examination, is normal. The patient returns to the office 2 weeks later and reports "on and off" headaches almost every day since his last visit.  The headaches are predominantly behind his left eye and are so severe that his left eye becomes watery and his forehead feels sweaty.  The headaches occur at approximately the same time each day and improve after resting in a dark, quiet room for about an hour.  Physical examination shows no abnormalities.  Which of the following is the most likely diagnosis?

• A)Anxiety disorder
• B)Cluster headache
• C)Migraine without aura
• D)Temporal arteritis
• E)Tension-type headache

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Definitions:

Par Value

The nominal or face value of a stock or bond as stated by the issuer, often used in the accounting of capital accounts.

Dividend

A share of a company's profits paid out to its shareholders, typically in the form of cash or additional stock.

Cumulative Preferred Stock

A type of preferred stock where missed dividend payments accumulate and must be paid out before any dividends can be issued to common stockholders.

Dividend

A portion of a company's earnings that is distributed to shareholders as a reward for their investment.