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13951 Medicine

A 22-years-old man presents with a history of a headache for 6 months which is mainly in the frontal region, occasionally associated with nausea. He has been taking paracetamol 3g per day, Hydroxycodeine 50 mg 3 times a day and Aspirin 300 mg 3 times a day for a headache but only with temporary relief from symptoms no focal signs on neurological examinations. What is the diagnosis?

ACluster headache
BMigraine
CDepression associated headache
DAnalgesic abuse headache
Medicine
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13957 Medicine

A 24-year-old man with a history of depression is brought to the emergency room because of a drug overdose. He is experiencing some nausea and vomiting, but no other symptoms. Physical examination and vital signs are normal. Six hours prior to presentation, he intentionally took 40 tablets of acetaminophen (500 mg/tablet). Which of the following is the most appropriate next step in management?

Agive ethanol to compete with the parent drug for metabolism, therefore preventing formation of toxic metabolites
Bgive Narcan to block its actions directly
Cgive intravenous prostacyclin's to maintain cellular integrity
Dgive N-acetylcysteine to allow binding of the toxic metabolite
Medicine
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