An 18-year-old woman comes to the office due to recurrent head | Uworld | Step 2ck

An 18-year-old woman comes to the office due to recurrent headaches. In the past, the patient has had occasional headaches, especially during term exams or other stressful situations. However, over the past 3 months, she has had 4 episodes of severe headache. They are always left sided, throbbing, associated with nausea, and spontaneously resolve after 12-24 hours. The patient also reports feelings of numbness and tingling in her extremities prior to the headaches. She has no chronic medical conditions and underwent an appendectomy several years ago. The patient is sexually active with her boyfriend and began taking combined oral contraceptives 6 months ago. Vital signs are within normal limits. Physical examination, including neurological examination, shows no abnormalities.