A 35 year old woman presents to her GP with a several month history of pounding headache which is at its worst in the morning. She also reports feeling nauseated. She has a background of asthma and has a BMI of 35. Neurological examination but fundoscopy shows swelling of the optic disc. Brain imaging is unremarkable and LP shows raised opening pressure but is otherwise normal. Given the likely diagnosis what is the most appropriate treatment?

A 60 year old gentleman is admitted to the medical assessment unit with a headache, fever and confusion for the last few hours. He had no past medical history of note. On examination, he has neck stiffness but no focal neurological signs and no evidence of rash. He is GCS 15/15. What is the most important initial investigation?

A 60 year old gentleman is admitted to the medical assessment unit with a headache, fever and confusion for the last few hours. He had no past medical history of note. On examination, he has neck stiffness but no focal neurological signs and no evidence of rash. He is GCS 15/15. The CSF results as follows. What is the diagnosis?

A 60 year old gentleman is admitted to the medical assessment unit with a headache, fever and confusion for the last few hours. He had no past medical history of note. On examination, he has neck stiffness but no focal neurological signs and no evidence of rash. He is GCS 15/15. Which of these is most important in the management of this patient in addition to antibiotics?

A 30 year old lady presents with a three-month history of episodes of headache. The headaches can start any time of the day and last hours, with associated nausea. They resolve after the patient goes to lie down in a dark room. There are no visual changes. The headaches are occurring around once per week and are causing the patient to miss days of work. The patient is usually fit and well. She takes paracetamol when the headache occurs which doesn’t help and takes microgynon 150/30 OD. On fundoscopy you see the following (see comments of post). What is the most likely diagnosis?

A 30 year old lady presents with a three-month history of episodes of headache. The headaches can start any time of the day and last hours, with associated nausea. They resolve after the patient goes to lie down in a dark room. There are no visual changes. The headaches are occurring around once per week and are causing the patient to miss days of work. The patient is usually fit and well. She takes paracetamol when the headache occurs which doesn’t help and takes microgynon 150/30 OD. On fundoscopy you see the following (see comments of post). She reports the headache has just started now and is severe. Which of the following treatment would you prescribe?

A 30 year old lady presents with a three-month history of episodes of headache. The headaches can start any time of the day and last hours, with associated nausea. They resolve after the patient goes to lie down in a dark room. There are no visual changes. The headaches are occurring around once per week and are causing the patient to miss days of work. The patient is usually fit and well. She takes paracetamol when the headache occurs which doesn’t help and takes microgynon 150/30 OD. On fundoscopy you see the following (see comments of post). The headaches settle with once-off doses of sumatriptan although she is having to use this two-three times/week. What treatment would you start?

A 30 year old lady presents with a three-month history of episodes of headache. The headaches can start any time of the day and last hours, with associated nausea. They resolve after the patient goes to lie down in a dark room. There are no visual changes. The headaches are occurring around once per week and are causing the patient to miss days of work. The patient is usually fit and well. She takes paracetamol when the headache occurs which doesn’t help and takes microgynon 150/30 OD. On fundoscopy you see the following (see comments of post). The headaches settle with once-off doses of sumatriptan although she is having to use this two-three times/week. What treatment would you start?

A 50 year old man presents to A&E with a sudden onset headache which came on 2 hours ago. He has associated nausea and neck stiffness. Examination is unremarkable. He is apyrexic but sensitive to the light. CT head is NAD however on lumbar puncture, CSF is positive for xanthochromia. What is the most likely underlying cause of this current event?