A 70-year-old white female (Mrs. Collins) comes to the office today as an add-on urgent visit. She reports “not feeling well
A 70-year-old white female (Mrs. Collins) comes to the office today as an add-on urgent visit. She reports “not feeling well” over the past couple of days with feelings of fatigue, fever, and having a bad headache. The onset of headache was 2 days ago, is not letting up, and last night it was difficult to fall asleep. Describes headache pain as a sharp, deep ache that throbs at times. Describes the headache as constant with periods of increased intensity. Chewing and sudden movements and activities such as simply washing her hair also aggravate pain. Associated symptoms of headache include nausea with decreased appetite but no vomiting. On a scale of 1 to 10, she rates her pain as a 4 at its best and 8 at its worse. She tried acetaminophen, two 500-milligram tablets, last night with minimal relief. Nothing really makes it better. She admits to a long history of migraine headaches since adolescence but has not had a bad one in years, and she added, “This feels very different.” She admits to continued occasional headaches that she attributes to stress, lack of sleep, or eating trigger foods such as dark chocolate. However, these headaches are not th
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