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A 38-Year-Old Woman Arrives to the Emergency Department After Experiencing

Question 274

Multiple Choice

A 38-year-old woman arrives to the emergency department after experiencing headache, nausea, and photophobia for two days. She has suffered migraines since her early twenties, but they have become more common in recent years. The current headache is more severe than normal, and ibuprofen provided little relief. The symptoms were preceded by a flu-like condition. The temperature is 38.3 C (100.9 F) , the blood pressure is 144/86 mm Hg, and the pulse rate is 110 beats per minute. The patient seems tired. Cranial nerves, sensory, and motor capabilities are all normally functioning. When asked to touch her chin to her chest, she complains of neck ache. There is no skin rash. A noncontrast CT scan of the head reveals no anomalies. Which of the following is the best next step in this situation's management?


A) 100% oxygen inhalation
B) Lumbar puncture
C) Metoclopramide
D) MRI of the brain
E) Sumatriptan
F) Topiramate

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