By the end of Family Medicine Clerkship, students will be able to:
1. Perform a patient-centered interview that identifies:
a. Symptoms of secondary headaches, including red flags of potentially serious causes: e.g. intracranial bleed, meningitis, etc.
b. Features that may differentiate types of headache that commonly presents in primary care e.g. migraine, tension, cervicogenic, and medication over-use headaches.
2. Perform a focused physical exam that identifies signs of secondary causes, including potentially serious causes.
3. Use diagnostic criteria to diagnose a patient with migraine.
4. Propose a management plan that includes:
a. Appropriate and timely investigation & disposition if a potentially serious secondary cause is suspected.
b. Includes appropriate evidence-informed pharmacological and non-pharmacological modalities.
c. Response to patient fears and expectations providing reassurance when appropriate
Recommended Resources Addressing the Objectives
Evaluation of acute headaches in adults (8 pages)
Objectives covered: 1ab, 2, 3, 4a
Clinch CR. Evaluation of acute headaches in adults. Am Fam Physician 2001 Feb 15;63(4):685-692.
Breaking the cycle of medication overuse headache (7 pages)
Objectives covered: 1b, 4bc
Tepper SJ, Tepper DE. Breaking the cycle of medication overuse headache. Cleve Clin J Med 2010 Apr;77(4):236-242.
TOP Guidelines for Primary Care Management of Headache in Adults (2 pages)
Objectives covered: 4bc
Towards Optimized Practice (TOP). Guideline for Primary Care Management of Headache in Adults. 2012; Available at: http://www.topalbertadoctors.org/download/600/Quick%20Reference.pdf. Accessed July/15, 2014.
The Calgary Guide – Pathophysiology behind why headaches occur
Top 10 causes of headache in family medicine, plus clinical pearls (1 page)
Objectives covered: 1a, 4c
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: Headache. Can Fam Physician 2007 Oct;53(10):1733.