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a 60 something male with headaches early morning since 2 weeks. no other history given. no other complaints. fundoscopy shows bluring of disc margins.
a)indomehacin
2)ct scan
3)refer to neurophysician
4)refer to neurosurgeon
now i thought this could be cancer in which case we start with mri. choice not given, so i thought we could send him to surgeon who''l image and perform surgery or whatever the heck. but answer is bb...is it pseudotumor cerebri? the blurring ofoptic disc not seen in other causes of raised ICT?
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in this case it sure looks like cns tumor,pseudotumor?mmmm....i would have guessed in an obese female.anyhow we do have to see whatever is wrong there so ct scan.for the sake of answering the qs i would stay away from referrals.
for pseudotumor i guess we have to see openning pressure and in someone with papilledema we don't do lp.
anyway what's in explaination?
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new onset hedache after 50
morning headache
hedache changing character
worst hedache
next step ct to rule out brain patho....ct plain first because u want to rule out bleed first
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ct without contrast would be for acute onset headaches. mri gives a better picture of brain, we start with mri for tumors suspecting headaches
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suspicious neurological headacvhe always do plain ct first and than refer.....
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nna....have a very low threshold to referral patient.atleast in s3.
nimishkum.....u have a tunnel vision.improve on it.it wont help in s3.
bregkamp....i agree with you.even i would have easily marked this as 44444 ( brain tumor and hence better to send him to an expert)
but i guess it could also be an hypertensive crisis??????? which could advocate ruling out hemorrhage before referring him
having said that i think its a tricky q...typically s3
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bergkamp,
i am not looking ques because i will take later before my exam.
but i have explanation of cd ques.
do you need that?
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target99..atleast i have tunnel vision but u dont have any vision.......i dont need help for s3 i am already done with it.....
fundoscopy so blurring of disc margin so its papilloedema
always in case of neurological headache plain ct first.......
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nimishkum....cool down man.
i didn't mean to offend u. was just a suggestion.free advice.
