Description

Problem Statement – Version 1

Bebe Babbitt a 26 year old female college student with complaints of headaches, denies signs and symptoms at date of service, for about the past 10 years, noting that they occur about every 1-2 months but have increased in frequency to every 1-2 weeks. She states that they feel like a “hat band from hell” noting 8-10/10 on pain scale, associated with nausea and vomiting, precipitating with blurred vision and zig-zaggy floaters left eye greater than right about 30 minutes before onset of headache, with photophobia and phonophobia, with headaches lasting about 15 hours. Pain is relieved with OTC acetaminophen or ibuprofen and rest-somewhat, but increased frequency raised concerns of “brain tumor” and is interfering with school and work responsibilities. PMH reveals similar pattern of headaches, increased stress. Mother has similar headaches. All cranial nerves grossly intact. Denies chest pain, seizure, dizziness or shortness of breath.

Problem Statement – Version 2

BB is a 26 year old female college student with a history of headaches for 10 years presents with worsening headaches. Her examination is notable for a family history of headaches, headaches with associated photophobia, phono-phobia, pain on left side behind eye, and nausea and vomiting increased in frequency of every 1 to 2 weeks. Patient has bilateral, preceding, scintillating scotomas prior to headaches and has a normal neurological exam.

Problem Statement – Version 3

BB is a 26-year-old female graduate student with a 10-year history of headaches who presents today with debilitating unilateral headaches on the left side behind her eye, that have increased infrequency and intensity over the past two months. BB reports the headaches now occur every 1-2 weeks, lasting up to 15 hours. The patient reports having big stressors in her life related to juggling the heavy load of graduate school, working part-time as a waitress, and consumption of red wine, chocolate and junk food that may be contributing factors to these headaches. BB reports premonitory blurred vision, photophobia, phonophobia, and nausea and vomiting with the onset of the headache episodes. The patient’s vital signs, physical examination including neurological exam are within normal limits at this time. Patient states she does not have headache at this time, but she is concerned about a possible slow growing brain tumor.