Instructions
You are a medical student on placement in general practice. Your next patient is Kirsty Halloway, 42, a bookkeeper with headaches on most days for six months. The GP has diagnosed medication-overuse headache and asked you to explain it and the plan.
Explain the diagnosis and your management plan to the patient
- You do not need to take a history or examine the patient.
- The examiner will ask you one question at the end.
GP's history today
Migraine without aura since age 16, previously 2 or 3 attacks a month. For 6 months, a dull frontal headache on about 25 days a month, often present on waking, plus 4 or 5 stronger migraine attacks a month. No red flag features.
Medicines and background
Paracetamol 500 mg with codeine 30 mg, 2 tablets, on about 20 days a month for over a year; ibuprofen 400 mg on most other days. Mild asthma, salbutamol inhaler a few times a year. Hormonal IUD. No known allergies.
GP's examination today
Neurological examination normal, including fundi. No neck stiffness.