[42F] With severe headache, nausea, and back pain

Patient Description

A 42-year-old female presents with a severe headache for the past two days, located in the center of the forehead above the nose and on the right side near the temple. The headache is described as a sharp, steady pain that worsens when bending over and is unresponsive to naproxen, ibuprofen, or Tylenol. The headache onset was sudden upon waking. The patient also reports nausea, vomiting, diarrhea, and back pain above the kidneys, suspecting it might be related to the lungs. She has a fever that comes and goes. The patient has a history of blood clots in the legs that traveled to the lungs, causing congestive heart failure and requiring surgery last year. Since then, she has experienced mild shortness of breath. Additionally, she reports intermittent blurry vision and calf pain when walking. There are no issues with speech or limb movement. The patient has run into a fan a few times but denies significant head injuries. She has degenerative disc syndrome, causing chronic neck pain, and light exposure exacerbates her headache. The patient has attention deficit disorder, making it difficult to concentrate or think clearly. She is currently not on any medications and is unsure if she needs to visit the emergency room.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several serious conditions that could be causing your symptoms:

  1. Migraine or Severe Headache: Given the location and nature of your headache, it could be a severe migraine or another type of headache. Migraines can cause nausea, vomiting, and sensitivity to light.

  2. Kidney Infection (Pyelonephritis): The back pain above your kidneys, along with fever, nausea, vomiting, and diarrhea, could indicate a kidney infection. This is a serious condition that requires prompt medical treatment.

  3. Blood Clots: Given your history of blood clots, it's crucial to consider the possibility of new clots, especially since you mentioned calf pain and shortness of breath. Blood clots can be life-threatening if they travel to the lungs (pulmonary embolism).

  4. Meningitis: The combination of a severe headache, fever, nausea, vomiting, and sensitivity to light could be signs of meningitis, an infection of the protective membranes covering the brain and spinal cord. This is a medical emergency.

  5. Hypertensive Crisis: If you have a history of high blood pressure, a severe headache and other symptoms could indicate a hypertensive crisis, which requires immediate medical attention.

What you can do

  1. Seek Immediate Medical Attention: Given the severity and combination of your symptoms, it is crucial to seek immediate medical attention. Please go to the emergency room as soon as possible. If you are unable to get there yourself, call 911 or have someone drive you.

  2. Monitor Symptoms: While waiting for medical help, keep track of any changes in your symptoms, such as worsening headache, increased pain, or new symptoms like confusion or difficulty breathing.

  3. Stay Hydrated: Try to drink small sips of water to stay hydrated, especially since you have been vomiting and have diarrhea. However, do not force yourself to drink if it makes you feel worse.

  4. Avoid Straining: Since bending over worsens your headache, try to avoid activities that require you to bend or strain.

  5. Rest: Lie down in a comfortable position and try to rest while you wait for medical help.

Remember, I am not a doctor, and this advice is based on the information you have provided. It is essential to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your symptoms are serious and require immediate medical attention.

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5 mo ago

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People Also Ask

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

Common symptoms of a migraine include a severe headache, nausea, vomiting, and sensitivity to light and sound. Management often involves resting in a dark, quiet room, staying hydrated, and taking prescribed medications such as triptans or anti-nausea drugs. It's important to consult a healthcare provider for a proper diagnosis and treatment plan.

How can you tell if you have a kidney infection and what should you do about it?

Symptoms of a kidney infection (pyelonephritis) include back pain, fever, nausea, vomiting, and sometimes painful urination. If you suspect a kidney infection, it's crucial to seek medical attention promptly as it requires antibiotics and can lead to serious complications if untreated.

What are the signs of a blood clot and why is it important to seek medical attention?

Signs of a blood clot include swelling, pain, and redness in the affected area, often in the legs. Shortness of breath and chest pain can indicate a clot has traveled to the lungs (pulmonary embolism). Immediate medical attention is necessary as blood clots can be life-threatening.

What are the symptoms of meningitis and why is it considered a medical emergency?

Symptoms of meningitis include a severe headache, fever, nausea, vomiting, neck stiffness, and sensitivity to light. It is considered a medical emergency because it can rapidly lead to serious complications, including brain damage or death, if not treated promptly with antibiotics or antiviral medications.

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