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BB2 > 19 - Headache + Migrane > Flashcards

19 - Headache + Migrane Flashcards

1
Q

Difference between a primary and secondary headache

A

Primary - Diagnosis without physical signs

Secondary - Diagnosis with physical signs

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2
Q

Percentage of headaches that are tension-type

A

80%

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3
Q

What do tension type headaches feel like

A

Band like, bilateral, tightness, pressure, dull ache

Radiate to neck and shoulders - mild to moderate

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4
Q

How do you treat a tension type headache

A

Analgesics

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5
Q

Percentage headaches that are cluster headaches

A

0.2 - 0.3%

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6
Q

Features of a cluster headache

A

Severe pain on one side of the head
Triggered by sleep
More common in men

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7
Q

Treatment of cluster headache

A

High flow oxygen - vasoconstriction

Highly caffinated drinks

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8
Q

Percent that are migraines

A

15%

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9
Q

Features of migraine

A

need 2/3

Light bothers you, headache limits ability to work, feel nauseated/sick

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10
Q

What do you inherit in genetics of migraine

A

Inherit over responsive brain

Heightened senses to smell, light, sounds and touch

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11
Q

Migraine triggers

A

Hormones
Lack of food
Lack of sleep
Dehydration

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12
Q

% migraines without aura

A

70-80%

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13
Q

% migraines with aura

A

20-30%

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14
Q

When does the migraine start

A

Usually 48hours before the headache starts

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15
Q

What happens to 5HT levels during a migraine

A

They increase

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16
Q

What happens if you deplete serotonin

A

It can trigger a migraine

Serotonin infusions - can relieve a migraine

17
Q

Acute drug class for migraine

A

Triptans

18
Q

Prophylactic drug for migraine

A

Methysergide

19
Q

5 stages of Migraine

A 
Premonitory 
Aura
Headache
Resolution
Recovery
20
Q

Premonitory Symptoms

A

Food craving
Neck pain
Fluid retention

21
Q

What is an aura

A

Visual and/or sensory and/or speech and language problems

22
Q

How long does and aura last

A

20/30 mins - 1hour

23
Q

What causes an aura

A

Cortical Spreading Depression

24
Q

Features of headache phase

A

Poor concentration
malaise
lethargy
heightened sense of smell

25
Q

What pathway does headache go through

A

Trigeminovascular pathways

26
Q

What happens in headache pathway

A

Inflammatory neuropeptides such as CGRP are released
These activate the nerve pathway
Pain signals are sent to the trigeminal ganglion
Trigeminal nerve transmits pain impulses to trigeminal nucleus caudalis
Pain impulses to thalamus –> Cerebral Cortex

27
Q

What mediates throbbing pain

A

Peripheral sensitisation

28
Q

Role of CGRP

A

Vasodilator

Levels RISE in migraines

29
Q

MoA of triptans

A

5HT1D/B agonists

30
Q

Examples of triptans

A

Zolmatriptan
Naratriptan
Eletriptan

31
Q

CGRP monoclonal antibodies

A

Used for prevention

Fremanezumab

BB2 (27 decks)

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