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NMSP Exam 1 > Approach to HA > Flashcards

Approach to HA Flashcards

1
Q

Benign HA disorders

A 
Migraine (Acute or Chronic)
Tension 
Cluster
Post-traumatic
Drug rebound 
Trigeminal Autonomic Cephalgias (TACs)
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2
Q

Describe an aura

A

any sort of sensory disturbance that precedes a migraine.

Most commonly visual disturbance

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3
Q

Common associated symptoms of a HA

A

N/V
Anorexia
Photo/Phonophobia
Dizziness

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4
Q

Common Triggers of HA

A 
Hormones 
Diet
Stress
Environment
Sensory stimuli
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5
Q

Important things to assess in history for a HA complaint

A 
Number
Duration 
Pain quality 
Prodrome (aura)
Meds
LOC
Seizure
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6
Q

PE for HA exam

A 
Vitals
Cardiac status
Cervical OSE 
Optic exam 
CN exam
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7
Q

Patient reports “worst HA of their lives”. DDX?

A

Aneurysm/hemorrhage

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8
Q

Signs of secondary HA

A

“worst HA”
>50y
HA with fever
Abrupt

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9
Q

Common causes of bacterial Meningitis

A

S. Pneumo
H. Flu
Nisseria
Listeria

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10
Q

Common viral causes of meningitis

A

HSV
HIV
West Nile

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11
Q

Common fungal causes of meningitis

A

Crypto Neoformans
Toxoplasmosis (TORCH)
Granulomatous disease (Sarcoid)

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12
Q

Signs and symptoms of meningitis

A

Fever
Stiff neck
Seizure
NV with HA

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13
Q

Empiric treatment for suspected meningitis

A

IV Vanc + 3rd gen cephalosporin (ceftriaxone) + Steroid + Acyclovir (prophylactic for HSV)

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14
Q

Tests to perform for suspected meningitis

A

Blood cultures

Lumbar puncture

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15
Q

CSF findings in bacterial meningitis

A

Elevated opening pressure
Elevated WBC (PMN)
Elevated PRO
DECREASED GLU

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16
Q

CSF findings in viral meningitis

A

Normal Opening pressure
Lymphocytosis
Normal PRO
Normal Glucose

17
Q

what would you call inflammatory process of the brain with neurologic dysfxn and is mainly causes by viruses?

A

Infectious Encephalitis

18
Q

Common causes of infectious encephalitis

A

HSV 1 and 2
West Nile
Varicella Zoster
Syphilis

19
Q

Infectious Encephalitis causes by HSV1 has a preference for what lobe of the brain and can develop what?

A

Temporal. Leads to fever, HA, ALOC, Seizures

Can lead to secondary autoimmune encephalitis

20
Q

Autoimmune encephalitis

A

Anti-NMDA Ab or LGI1
rapidly progressive encephalopathy/psych disturbances with seizures.
Look for history of HSV-1 Encephalitis

21
Q

NMDA encephalitis

A 
Middle-aged Females
Rapid onset <3m 
4/6 of the following: 
Psych disturbane
speech problem
seizure
Dyskinesia
ANS dysfxn 
ALOC
22
Q

What would be seen on EEG in a patient with NMDA encephalitis that is basically diagnostic?

A

Delta Brush

23
Q

What neoplasia is associated with NMDA encephalitis?

A

Teratoma

24
Q

A male patient begins to have dystonic seizures involving the face and arm that does not resolve with AED. What could be a possible diagnosis?

A

LGI1 Encephalitis
M>F
Sleep disturbances
Hippocampus mainly effected

25
Q

Common Migraine characteristics

A 
Moderate to Severe
ADL's compromised
30-40y Females primarily 
1-4/month
Unilateral sharp pain 
NV
Photo/Phonophobia
26
Q

Chronic Migraine definition

A

> 15d/month
4h duration
3m

27
Q

Hypothesized cause of a migraine

A

Neurogenic inflammation of the meninges caused CN V activation

28
Q

Tension HA

A 
Mild/Moderate
Peak incidence 20-40y
Waxing/Waning
Band-Like distribution of dull aching squeezing pain
Bilateral
29
Q

Cluster HA

A

Severe/excrutiation pain usually orbitotemporal
ALWAYS unilateral
30m to 2h duration

30
Q

Acute Treatment of Migraine

A

Analgesics
NSAIDs
DHE nasal spray
Triptans (5HT1 agonists)

31
Q

Preventative treatment of Migraine

A 
TCAs 
SSRIs 
SNRIs
MAOIs 
B-Blockers
CCB's 
AED's 
Literally every god damn drug class we're learning right now
32
Q

Newest and promising treatment of Chronic Migraines

A

BOTOX injections every 3m

33
Q

Acute treatment for cluster HA

A

O2 8L/min by mask
Triptans
Lidocaine

34
Q

Trigeminal Neuralgia

A

aka “tic douloureux”
Excruciating CN V pain
Tx: Carbamazepine (Na channel blocker)

NMSP Exam 1 (17 decks)

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