He smokes half a pack of cigarettes a day and drinks alcohol socially. His paternal uncle died of an aortic dissection at age 42. He says he has anxiety and takes alprazolam as needed. He reports that the pain is worse with inspiration and does not radiate. This event started when he was in class sitting for an exam. Which of the following additional clinical findings would you expect to be present?Ī 23-year-old man comes to the emergency department presenting with sudden-onset dyspnea and right-sided chest pain over the last hour. A computed tomography (CT) scan of his head is shown in the exhibit. The rest of the examination is within normal limits. An area of bluish discoloration is seen on his left eyelids and cheek. His height and weight are at the 67th and 54th percentile for his age. Physical examination reveals normal vital signs. There is no history of fever or head trauma. His developmental milestones were slightly delayed. His birth history and family history are not available. Past medical history is significant for mild mental retardation and complex partial seizures sometimes leading to secondary generalized seizures. The headaches are moderate-to-severe in intensity, unilateral, mostly affecting the left side, and pulsatile in nature. Students: Educators’ Pro Tips for Tough TopicsĪ 10-year-old boy is brought to a family physician by his mother with a history of recurrent headaches.Maternity Nursing and Care of the Childbearing Family.
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