[22F] Experiencing severe headache, cough, and nausea

Patient Description

A 22-year-old female presents with a severe headache described as sharp and throbbing, located behind the eyes and temples, which started upon waking up and has persisted throughout the day. The patient has a history of constant headaches, but notes this one as being particularly worse. Accompanying symptoms include a sore throat, described as painful with a sensation similar to swallowing sandpaper, and a cough rated around 5 or 6 in severity, which began yesterday. The patient also reports severe nausea, with a cramp-like abdominal pain rated 2 in severity, and a feeling of being hot and clammy with cold sweats that started late last night. The patient's nose is very runny, and there is a heightened sensitivity to light exacerbating the headache. There is no fever, chills, neck stiffness, rash, sudden changes in mental status, or recent history of substance use. The patient's last bowel movement was a day ago and appeared normal. No family history of migraines or other types of headaches is reported, and there is no mention of pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Migraine: A type of headache characterized by severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment of migraines often involves over-the-counter (OTC) pain relievers and rest in a quiet, dark room. Prescription medications may also be used to alleviate symptoms or prevent future attacks.
  • Tension Headache: A common type of headache characterized by a dull, aching sensation all around your head. It's often described as feeling like a tight band around your forehead or at the back of your head. Tension headaches are often associated with stress, anxiety, or muscle strain.

    • Treatment typically involves OTC pain relievers, rest, and stress management techniques.
  • Sinusitis: Inflammation or swelling of the tissue lining the sinuses, often associated with an infection. Symptoms can include headache, facial pain, runny nose, and cough.

    • Treatment typically involves OTC pain relievers, decongestants, and sometimes antibiotics if a bacterial infection is suspected.
  • Common Cold or Influenza (Flu): Viral infections that can cause a variety of symptoms including headache, cough, sore throat, and runny nose. The flu can also cause nausea and sweating.

    • Treatment typically involves rest, hydration, and OTC medications to manage symptoms.

What you can do

  1. Rest and hydrate: Ensure you're getting plenty of sleep and staying well-hydrated, especially if you're sweating more than usual.
  2. Over-the-counter medication: Consider taking an over-the-counter pain reliever for your headache and a decongestant for your runny nose and cough.
  3. Monitor your symptoms: Keep track of your symptoms and seek medical attention if they worsen or persist for more than a week.

What you should look out for

Reasons to seek immediate medical attention:

  • If your headache becomes severe and is the worst headache you've ever had
  • If you develop a high fever (temperature over 100.4°F)
  • If you have difficulty breathing or chest pain
  • If you become confused or have difficulty speaking or understanding speech
  • If you have a seizure

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of a migraine and how can they be managed?

Common symptoms of a migraine include severe throbbing pain or a pulsing sensation, usually on one side of the head, nausea, vomiting, and extreme sensitivity to light and sound. Management often involves over-the-counter pain relievers, rest in a quiet, dark room, and sometimes prescription medications to alleviate symptoms or prevent future attacks.


How can I differentiate between a tension headache and a migraine?

A tension headache is typically characterized by a dull, aching sensation all around the head, often described as a tight band around the forehead or at the back of the head, and is associated with stress or muscle strain. In contrast, a migraine is usually more severe, with throbbing pain on one side of the head, and is accompanied by nausea and sensitivity to light and sound.


What are the typical symptoms of sinusitis and how is it treated?

Typical symptoms of sinusitis include headache, facial pain, runny nose, and cough. Treatment usually involves over-the-counter pain relievers, decongestants, and sometimes antibiotics if a bacterial infection is suspected.


What should I do if my cold or flu symptoms worsen or persist?

If your cold or flu symptoms worsen or persist for more than a week, it's important to monitor your symptoms closely. Seek medical attention if you develop a high fever, difficulty breathing, chest pain, confusion, or any other severe symptoms.


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