NICE In My PracticeABDUL-RAHMAN GOMAA

PCMD - YEAR 5

10 T H JUNE 2015

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Case 1 19

Female

Presented with a 6 hour of one sided headache and aura

Recently diagnosed with migraine by GP and started on 5mg amitriptyline

Otherwise, fit and well.

Dilemmas: 1- How would we manage the acute migraine episode?

Case 1

Case 1 19

Female

Presented with a 6 hour of one sided headache and aura

Recently diagnosed with migraine by GP and started on 5mg amitriptyline

Otherwise, fit and well.

Dilemmas: 1- How would we manage the acute migraine episode?

2- How can we prevent further episodes?

Case 1

Case 1 - Outcome

Acutely

Long-term

Case 2 47

Female

Presented with a 2 day history of nasal congestion and facial discomfort.

Tried intranasal decongestant which didn’t help.

Had a similar episode last year, was prescribed antibiotics “which cleared her nose immediately”

Otherwise, fit and well.

Questions: Should we prescribe antibiotics?

Case 2

Case 2 - Outcome

Immediately

Long-term?

Questions

Thank youAGOMAA@NHS.NET