B7-001 Headache Flashcards

1
Q

4 characteristics of common migraines

A
  1. unilateral location
  2. pulsating quality
  3. moderate or severe pain
  4. aggravation by routine physical activity

must meet two of four

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2
Q

common migraines must cause what symptoms during the headache [2]

A

nausea/vomiting
OR
photophobia/phonophobia

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3
Q

migraine HA preceded/accompanied by visual, sensory, or other focal neurologic symptoms

A

migraine with aura

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4
Q

a migraine lasting longer than 72 hours

A

status migrainosus

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5
Q

4 characteristics of episodic tension-type headaches

A
  1. bilateral location
  2. pressing/tightening quality
  3. mild or moderate intensity
  4. not aggravated by physical activity

must meet 2 of 4 characteristics

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6
Q

chronic daily headache is defined as greater than […] days in a month

A

15

can be chronic tension type or chronic migraines

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7
Q

a headache must have [….] cause to be classified as a migraine

A

no identifiable cause

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8
Q

most common theory about cause of migraines

A

Trigeminal-vascular theory

(release of CGRP by 5HT1R causes sensitization)

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9
Q

5HT1 agonists used for headache [3]

A

ergotamines (dihydroergotamine)
triptans (sumatriptan)
Ditans (lasmiditan)

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10
Q

5HT1 agonist that does not cause vasoconstriction

A

ditans (lamiditan)

**safe in patients with CVD history

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11
Q

CGRP antagonists

A

-gepants (rimegepant)

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12
Q

most common cause of migraines transforming to chronic migraine is

A

overuse of symptomatic migraine drugs and/or analgesics

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13
Q

typically, if a patient has more than […] headaches a month you should offer prophylactic medications

A

4

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14
Q

botulinum toxin is helpful as prophylaxis for […]

A

chronic migraine

does not help unless they have progressed to chronic headaches as defined by >15 a month

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15
Q

medication classes used for migraine prophylaxis [7]

A

antiepileptics
beta blockers
antidepressants
NSAIDs
herbal therapies
botulinum toxin
CGRP receptor binding

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16
Q

most common primary headache syndromes [2]

A

migraine
tension-type

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17
Q

severe unilateral peri-orbital pain lasting 15-180 min

A

cluster headache (trigeminal autonomic cephalgia)

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18
Q

autonomic features associated with cluster headache (trigeminal autonomic cephalgia)

A

conjunctival injection
lacrimation
rhinorrhea
miosis
ptosis
eyelid edema

19
Q

what signs make a patient unlikely to have a sinister cause of their headaches?

A

long history of similar headaches with a benign outcome and normal neuro exam

20
Q

red flags in chronic headache [4]

A

onset > 35 years old
neurologic findings, AMS
elevated ICP (papilledema)
inflammation, fever, stiff neck

21
Q

types of primary headaches [3]

A

tension type
migraine
cluster

22
Q

causes of secondary headaches

A

medication overuse
meningitis
subarachnoid hemorrhage
hydrocephalus
neoplasia
giant cell arteritis

23
Q

tension type headaches are [bilateral/unilateral]

A

bilateral

24
Q

migraine headaches are [bilateral/unilateral]

A

unilateral

25
Q

cluster headaches are [bilateral/unilateral]

A

unilateral

26
Q

last >30 min (typically 4-6 hours)
are constant

A

tension-type

27
Q

last 4-72 hrs

A

migraine

28
Q

last 15min- 3 hrs
repetitive

A

cluster

29
Q

steady, bandlike pain

A

tension-type

30
Q

symptoms of migraine

A

Pulsatile
One-day duration
Unilateral
Nausea
Disabling

POUND (from FA p. 534)

31
Q

excruciating periorbital pain with autonomic symptoms

A

cluster

32
Q

may present with Horners syndrome
more common in males

A

cluster

33
Q

treatment for hemicrania continua

A

indomethacin

34
Q

acute thunderclap headache

A

aneurysm

35
Q

an otherwise typical migraine lasting longer than 72 hours

A

status migrainosus

36
Q

most common cause of transformed migraine

A

medication overuse

37
Q

transformed migraines and continuous tension type headaches are diagnosed when a patient suffers headaches […] day a month

A

15 or more days

38
Q

a B12 or toxin would cause [pattern] symptoms and signs

A

bilateral symmetric

39
Q

a midline structural process would cause [pattern] symptoms and signs

A

bilateral symmetric

40
Q

a focal structural process would cause [pattern] symptoms and signs

A

unilateral, non-symmetric

41
Q

unilateral
<3 hours in duration
ipsilateral rhinorrhea, eye injection, miosis, ptosis

A

cluster headache syndrome

42
Q

most common headache disorder for which patient seek help from physicians

A

migraine

(tension type is most common overall)

43
Q

migraine therapy with no vasoconstrictive properties

A

-ditans (lasmiditan)

44
Q

migraines are caused by

A

centrally mediated pain sensitization