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Is there a history of drug, caffeine, or alcohol ingestion? The hangover headache is well known and should not present a problem in diagnosis. Caffeine withdrawal headaches are also common because of the large amount of caffeine consumed in coffee, ... DIAGNOSTIC WORKUP
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Is there a history of exposure to drugs or toxins? Quinine, cocaine, atropine, and Apresoline® are just a few of the drugs that may cause photophobia.
Are there abnormalities on the eye examination? Almost any condition of the eye may ... DIAGNOSTIC WORKUP
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Headache is one of the most common primary care complaints. It may be an isolated or recurrent event; it may be idiopathic or secondary to an underlying structural lesion; or it may simply require an analgesic for pain relief or a complete and detailed workup for its source. One... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Photophobia is ocular pain or discomfort upon exposure to light. It may be a symptom of a primary ocular disorder or underlying central nervous system disorder and should always be evaluated, unless a known etiology (e.g., migraine headache) is present.
... Workup and Diagnosis ... Treatment
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By age 7, 40% of children will have experienced headaches. By age 15, this figure rises to 75%. Headache can be the presenting symptom of a neurologic emergency such as subarachnoid hemorrhage, or of a chronic and common disease such as migraine. The pattern of onset, duration, and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Nuchal rigidity is characterized by involuntary muscle spasms that limit passive neck flexion. Although it has myriad causes, meningeal irritation may occur secondary to infection, so patients must be evaluated emergently for meningitis/focal infection. Cervical muscle... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... This symptom is best analyzed by using anatomy, as seen in Tables 32 and 33 , but differentiation by pathophysiology is interesting, particularly in muscle traction headaches and migraines.
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... Finding nuchal rigidity on examination has almost invariably prompted the diagnosis of meningitis and lumbar puncture, but the astute clinician will want to consider other possibilities to avoid a potentially hazardous procedure. Anatomy is the
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... Sensitivity to light may be due to local eye disease or systemic disease, but in both cases it is usually due to inflammation, with three exceptions: albinism because there is poor pigmentation of the iris and choroid, allowing more light to get in; migraine,
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... A positive Brudzinski's sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips.
... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain About 90% of all headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Clinical features of... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Commonly an early sign of meningeal irritation, nuchal rigidity refers to neck stiffness that prevents flexion. To elicit this sign, attempt to passively flex the patient’s neck and touch his chin to his chest. If nuchal rigidity is present, this maneuver... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without underlying pathology. For example, it can stem from wearing contact lenses excessively or using poorly... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Muscle contraction (tension)
Migraine
Cluster (histamine) headache
Nonmigrainous vascular causes
Effort (physical activity)
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... Signs and Symptoms Sudden onset of fever, headache, vomiting, meningeal irritation (stiff neck and back), drowsiness, coma, paralysis, seizures, ataxia, psychoses
Treatment (Tx) Anticonvulsants, acyclovir (if viral... Pictures
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... The most common patient complaint, headache usually occurs as a symptom of an underlying disorder. Ninety percent of all headaches are vascular, muscle contraction, or a combination; 10% are due to underlying intracranial, systemic, or psychological disorders.... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Signs and Symptoms Nuchal rigidity, Brudzinski’s and Kernig’s signs, exaggerated deep tendon reflexes, opisthotonos, sinus arrhythmias, irritability, photophobia, deep stupor, coma
... Pictures
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... Two major meningococcal infections (meningitis and meningococcemia) are caused by the gram-negative bacteria Neisseria meningitidis, which also causes primary pneumonia, purulent conjunctivitis, endocarditis, sinusitis, and genital infection. Meningococcemia occurs as simple bacteremia... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Vitamin C (ascorbic acid) deficiency leads to scurvy or inadequate production of collagen, an extracellular substance that binds the cells of the teeth, bones, and capillaries. It’s essential for wound healing and burn recovery. Vitamin C is... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... West Nile encephalitis is categorized as an infectious disease that primarily causes an inflammation or “encephalitis” of the brain. West Nile virus (WNV), a flavivirus commonly found in humans, birds, and other vertebrates in Africa,... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... A positive Brudzinski’s sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips.
... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain. About 90% of all headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Comparing benign headaches, page 390.)... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Commonly an early sign of meningeal irritation, nuchal rigidity refers to stiffness of the neck that prevents flexion. To elicit this sign, attempt to passively flex the patient’s neck and touch his chin to his chest. If nuchal rigidity is present, this... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without any underlying pathology. For example, it can stem from excessive wearing of contact lenses or use of poorly fitted... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Robert B. Taylor
Headache is one of the 20 most frequent reasons patients visit primary care providers in the United States. Migraine headache, one of the common causes of recurrent headache, occurred one or more times... Approach. ... History ... Physical examination ... Testing ... Pictures
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... Differential Overview
❑ Migraine
❑ Tension
❑ Acute sinusitis
❑ Acute glaucoma
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
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... A severe inflammation of the brain, encephalitis is usually caused by a mosquito-borne or, in some areas, a tick-borne virus. Viruses transmitted by arthropods are arboviruses (arthropod-borne). Transmission by means other than arthropod bites may occur... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... The most common patient complaint, headache usually occurs as a symptom of an underlying disorder. Ninety percent of all headaches are vascular, muscle contraction, or a combination; 10% are due to underlying intracranial, systemic, or psychological disorders. ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... West Nile encephalitis, part of a family of vectorborne diseases that also includes malaria, yellow fever, and Lyme disease, is an infectious disease that primarily causes encephalitis (inflammation) of the brain. It’s caused by the West Nile virus (WNV), a flavivirus commonly... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... A positive Brudzinski’s sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips. ... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain. About 90% of all headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See
... READ EXCERPTS »
... Commonly an early sign of meningeal irritation, nuchal rigidity refers to stiffness of the neck that prevents flexion. To elicit this sign, attempt to passively flex the patient’s neck and touch his chin to his chest. If nuchal rigidity is present, this maneuver triggers... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without any underlying pathology. For example, it can stem from excessive wearing of contact lenses or use of... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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...In most children, headache is not due toa serious cause. Diagnostic dilemma is to determine which childrenhave serious underlying pathology. Principal Causes of Headache Tension-typeheadache Vascular headache Migraine ... Clinical Features and Diagnosis ... Table 25.1. Anatomic Location of Common Intracranial Neoplasms ... Diagnostic Approach ... References
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... A positive Brudzinski's sign (flexion of the hips and knees in response to passive flexion of the neck) signals meningeal irritation. Passive flexion of the neck stretches the nerve roots, causing pain and involuntary flexion of the knees and hips. ... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... The most common neurologic symptom, headaches may be localized or generalized, producing mild to severe pain. About 90% of headaches are benign and can be described as vascular, muscle-contraction, or a combination of both. (See Clinical features of headache, page... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Commonly an early sign of meningeal irritation, nuchal rigidity refers to neck stiffness that prevents flexion. To elicit this sign, attempt to passively flex the patient's neck and touch his chin to his chest. If nuchal rigidity is present, this maneuver triggers pain and muscle... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... A common symptom, photophobia is an abnormal sensitivity to light. In many patients, photophobia simply indicates increased eye sensitivity without an underlying disorder. For example, it can stem from wearing contact lenses excessively or using poorly fitted lenses. However, in others,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Finding nuchal rigidity on examination has almost invariably prompted
the diagnosis of meningitis and lumbar puncture, but the astute clinician
will want to consider other possibilities to avoid a potentially hazardous
procedure. Anatomy is... Pictures
... READ EXCERPTS »
...
Sensitivity to light may be due to local eye disease or systemic
disease, but in both cases it is usually due to inflammation, with three
exceptions: albinism because there is poor pigmentation of the iris and
choroid, allowing more light to get in;
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... Author:
Yolanda Lewis-Ragland, MD
What to Do - Interpret the Data
The first penicillin-resistant Streptococcus pneumoniae strain was isolated in
1967. Since then, however, there have been many reports of treatment failure
in patients with pneumococcal... Meningitis Signs and Symptoms ... Risk Factors for Developing Meningitis ... Management of Bacterial Meningitis ... Suggested Readings
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... Author:
Lindsey Albrecht, MD
What to Do - Gather Appropriate Data
The complement pathways make up an important part of the body's innate
immunesystem.Complementproteinsplayakeyroleindefenseagainstpyogenic organisms, and most congenital and acquired complement... Suggested Readings
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... Author:
Renée Roberts, MD
What to Do - Take Action
The guidelines for cardiopulmonary resuscitation (CPR) and emergency
cardiovascular care for pediatric and neonatal patients contains recommendations designed to... Suggested Readings ... Pictures
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... Jason Newland, MD
Louis Bell, Jr., MD
Meningitis - BASICS
Meningitis - description
Inflammation of the membranes of the brain or spinal cord, usually caused by bacteria, viruses, fungi, and... Meningitis - DIAGNOSIS ... Meningitis - TREATMENT ... Meningitis - FOLLOW UP ... Meningitis - bibliography ... Meningitis - CODES ... Meningitis - FAQ
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... Bacterial Meningitis
Epidemiology
Bacterial meningitis is the most feared form of pediatric meningitis. Bacteria,
which colonize the skin, nasopharynx, or both, enter the bloodstream. These
bacteria then
“seed” the CSF. It is for... Aseptic Meningitis ... Encephalitis
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Each year you hear about small outbreaks of meningitis. It is highly contagious and sometimes fatal. Learn why the classic symptoms of a high fever...
No matter how smoothly your pregnancy is going, there is always the possibility that you will need to have a c-section to deliver a healthy baby....
Whenever you go to a hospital or clinic for a major procedure or diagnostic test, one of the many forms you are given to sign is an "informed...
Sleep is necessary to feel refreshed, but now we know sleep actually impacts the way the body functions. Sleeping poorly can affect how often you get...