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BMB W10 > 10-16 L1 Headaches > Flashcards

10-16 L1 Headaches Flashcards

1
Q

Which headaches are based on age?

Which headaches are based on gender?

A
  • Age
    • Temporal arteries (geriatric pops)
    • Idiopathic intracranial hypertension (young)
  • Gender
    • Idiopathic intracranial hypertension (women)
    • Cluster headaches (men)
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2
Q

Pt has ‘worst headache of their life’ onset (seconds)

presents with Nuchal rigidity Hx: smoking (increases risk greatly)

  • Diagnosis?
  • Cause?
  • Treatment?
A
  • Subarachnoid hemorrhage
  • Cause: rupture of aneurysm
  • Treatment:
    • support
    • control extreme blood pressure
    • expert neurosurgery (A-team)
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3
Q

Pt has progressive worsening over weeks to months, vomiting preceding heache (seen in posterior fosa tumors) pt has hx of cancer.

  • Diagnosis
  • identifying the disease
  • What not to do
A
  • Brian tumor headache
    • Look for papilledema
    • focal neurological findings
  • Absces can do a perfect imitaiton
  • MRI with gadolinium is fantastic
  • DO NOT TAP
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4
Q

Which of the following headaches would you NOT perform a TAP on!

A
  • Brain tumor headache
  • Subdural hematoma
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5
Q

A 86 yo male,had a headache (hit his head). Pt noted behavioral changes:

  • Whats the diagnosis
  • risk factors
A
  • Chronic subdural hematoma
  • anticoagulation (warfarin) is a risk
  • DO NOT TAP!
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6
Q

A 75 yo woman has a severe head ache, altered mental status, fever and nuchal rigidity.

  • Whats your diagnosis
  • treatment?
A
  • Meningitis
  • Treatmetnt (treat first, then confirm)
    • IV antibiotics are chosed based on age and PMH
    • CT and lumbar puncture after antibiotics are started.
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7
Q

A 29 yo female, has a progressive heachade , pt was confirmed to have papilledmea (wi/otherwise normal neurological exam).m Normal CT w/elevated CSF pressure (>200 mm)

  • Whats your diagnosis
  • Adverse effects of disease
  • Treatement
A
  • Idiopathic Intracranila hypertension (pseudotumor Cerebri)
  • May cause blindness
  • Treatment:
    • repeated LP’s
    • Acetazolamide
    • Weight loss
    • Optic nerve sheath fenstration
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8
Q

Which two headaches can lead to blindness?

A
  • Idiopathic intracranial hypertension
  • Temporal Arteritis
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9
Q

a 99 yo femal has jaw claudication, tenderness of the temporal arteries, and malaise. Her CT reveals normal finding, but her Sedimentation rate is elevated.

  • What is the diagnosis?
  • Hallmark findings?
  • Adverse effects?
  • Treatment?
A
  • Temporal arteritis
  • Elevated sedimentation rate (ESR)
  • May cause blindess
  • Treatment
    • predinsone
    • confirm diagnosis w/temporal artery biospy
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10
Q

A 56 yo male, comes in w/ bp 220/120 complaining of a headache.

  • Whats your diagnosis
  • Cause
A
  • Hypertension and headache
  • caused by
    • interacranial masses
    • may lead to intracranial hemorrhage
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11
Q

A 63 yo pt as a headahce (4-72 hours in duration). She states that the build in intensity overa half hour. Pt noted vomiting and nause, and photophobia. Pt stated to have moderate or severe intense throbbing, unilateral or worsened with activity (but stated its improved by rest)

  • Whats your diagnosis?
  • What if this attack occurs >3/mo what would you call it.
    • treatment
A
  • Migraine headache
  • Prophylaxis
    • Treatment
    • amitriptyline
    • Valproic acid
    • Propranolol
    • Calcium channel blockers
    • _Non-pharmalogical _ by avoiding the cause.
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12
Q

What is the treatment of migraine headaches?

A
  • Seotonergic hypothesis
  • seotonergic drugs help
    • MOA: stimulation of the dorsal raphe nucleus causes headache
    • do not follow vascular distributions
    • spreading depresion of leao looks nural rather than vascular
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13
Q

What are some acute treatments of Migraine headaches?

A
  • Anti-inflammatory drugs
    • ASA, tylenol, Excedrin mirgraine, NSAIDs
  • 5-HT1B/D agonists
    • Triptans
    • Recurrence and cardiovascualr risk
  • Dopamine agonsits
    • Metaclopramide (and ASA) = sumatriptan
    • IV prochlorperazine
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14
Q

A 25 yo male, has a headache ‘behind my eyes’. Pt presents w/lacrimation, facial sweating, ptosis, red eye

  • Whats the diagnosis
  • What should you consider
  • treatement?
A
  • Cluster headache
  • Consider glaucoma
  • Treatment:
    • Oxygen
    • Prednisone/verapamil
    • lithium sumatriptan (SQ)
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15
Q

A 45 yo male pt has a headache that lasts 72 hours, (more than 50% of the days)

  • What is your diagnosis
  • Treatment
A
  • Tension-type headaches
  • Treament:
    • Amitriptyline
    • Acetaminophen
    • Non-pharmacological
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16
Q

Which two headaches can be treatmented non-pharmacological?

A
  • Tension-type headache
  • Migraine headache

BMB W10 (9 decks)

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