Question

A 40-year-old previously healthy female presents with sudden onset of a severe occipital and nuchal headache following a coughing fit. Vital signs and physical examination are normal. Which of the following is indicated? (A) Contrast CT scan of the brain followed by lumbar puncture if negative. (B) Noncontrast CT scan of the brain followed by lumbar puncture if negative. (C) MRI scan of the brain. (D) Trial of pain medication and CT scan of the head and lumbar puncture only if headache is unrelieved.

   A 40-year-old previously healthy female presents with sudden onset of a severe occipital and nuchal headache following a coughing fit. Vital signs and physical examination are normal. Which of the following is indicated?
(A) Contrast CT scan of the brain followed by lumbar puncture if negative.
(B) Noncontrast CT scan of the brain followed by lumbar puncture if negative.
(C) MRI scan of the brain.
(D) Trial of pain medication and CT scan of the head and lumbar puncture only if headache is unrelieved.

Emergency Medicine Examination & Board Review

Susan Promes 3rd Edition

Chapter 15, Problem 5

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The sudden onset of a severe occipital and nuchal headache following a coughing fit could be indicative of a subarachnoid hemorrhage, which is a medical emergency. Show more…

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A 40-year-old previously healthy female presents with sudden onset of a severe occipital and nuchal headache following a coughing fit. Vital signs and physical examination are normal. Which of the following is indicated? (A) Contrast CT scan of the brain followed by lumbar puncture if negative. (B) Noncontrast CT scan of the brain followed by lumbar puncture if negative. (C) MRI scan of the brain. (D) Trial of pain medication and CT scan of the head and lumbar puncture only if headache is unrelieved.

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