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Physical Assessment > Chapter 19; Module 6; Headache > Flashcards

Chapter 19; Module 6; Headache Flashcards

1
Q

Common in adults; bilateral pain, general or localized in bandlike distribution; history of anxiety, stress, or depression

A

Tension-type headache (muscle)

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2
Q

Normal physical examination;neck muscle tightness or fasciculations may be palpated

A

Tension-type headache (muscle)

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3
Q

DIAGNOSTIC STUDIES OF Tension-type headache (muscle)?

A

NONE

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4
Q

More common in children; unilateral, throbbing pain; nausea

A

Migraine without aura (common)

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5
Q

Photophobia and phonophobia

A

Migraine without aura (common)

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6
Q

DIAGNOSTIC STUDIES OF Migraine without aura (common)?

A

None

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7
Q

Pain precipitated by environmental stimuli; visual disturbances (scintillating scotoma) precede pain

A

Migraine with aura (classic)

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8
Q

Nausea and vomiting, photophobia and phonophobia

A

Migraine with aura (classic)

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9
Q

DIAGNOSTIC STUDIES OF Migraine with aura (classic)?

A

None

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10
Q

Throbbing, constant pain during waking hours; muscle tightness; family history of migraine

A

Mixed headache

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11
Q

Mix of findings related to tension and migraine headache pain

A

Mixed headache

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12
Q

DIAGNOSTIC STUDIES OF Mixed headache?

A

None

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13
Q

Rare in children; abrupt, nighttime onset; unilateral periorbital pain that is severe

A

Cluster headache

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14
Q

Ipsilateral rhinorrhea, nasal stuffiness, conjunctival injection, sweating, ptosis

A

Cluster headache

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15
Q

DIAGNOSTIC STUDIES OF Cluster headache?

A

none

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16
Q

Sudden onset related to physical exertion, Valsalva maneuver, or coitus

A

Benign exertional headache

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17
Q

Normal physical examination

A

Benign exertional headache

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18
Q

DIAGNOSTIC STUDIES OF Benign exertional headache?

A

May need to distinguish from subarachnoid hemorrhage with CT scan

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19
Q

Frontal, upper molar, or periorbitalpain; cough, rhinorrhea

A

Sinusitis

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20
Q

Low to no fever; pain on palpation of frontal, maxillary sinuses; purulent nasal or postnasal discharge

A

Sinusitis

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21
Q

DIAGNOSTIC STUDIES OF Sinusitis?

A

Radiographs (Waters view)

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22
Q

Localized pain in jaw and top of head

A

Dental disorders

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23
Q

Malocclusion, caries, abscesses of teeth present, gum disease

A

Dental disorders

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24
Q

DIAGNOSTIC STUDIES OF Dental disorders?

A

Dental referral

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25
Sore  throat
Pharyngitis
26
Fever;  infection  of  posterior pharynx
Pharyngitis
27
DIAGNOSTIC STUDIES OF Pharyngitis?
Throat  culture
28
Ear  pain,  pain  with  swallowing
Otitis  media
29
Fever;  red,  bulging  tympanic membrane
Otitis  media
30
DIAGNOSTIC STUDIES OF Otitis  media?
None
31
Severe  headache,  chills,  myalgias, stiff  neck;  toxic  child  or  adult
Meningitis
32
Positive  Kernigand  Brudzinski signs;  fever,  photophobia, petechial  rash  may  be  present;  mental  status  changes
Meningitis
33
DIAGNOSTIC STUDIES OF Meningitis?
Lumbar  puncture
34
People  >55  yr;  bursts  of  sharp pain  over  face  innervated  by affected  nerve ;  triggered  by stimulus  to  affected  nerve
Trigeminal  neuralgia
35
Normal  physical  examination; stimulation  of  triggers  may provoke  pain
Trigeminal  neuralgia
36
DIAGNOSTIC STUDIES OF Trigeminal  neuralgia?
None
37
Acute  onset  of  pain  with  extraocular  movement  (EOM),  followed by  blurred  vision
Optic  neuritis
38
Diminished  visual  acuity, decreased  papillary  reflex, hyperemia  of  optic  disc; pain  with  EOM
Optic  neuritis
39
DIAGNOSTIC STUDIES OF Optic  neuritis?
Ophthalmology  referral
40
May  have  history  of  trauma; occipital  pain,  muscle  stiffness
Cervical  spine disorders
41
Normal  physical  examination or  pain  associated  with  neck motion
Cervical  spine disorders
42
DIAGNOSTIC STUDIES OF Cervical  spine disorders?
Cervical  spine radiographs
43
Age  >50  yr;  sharp,  localized temporal  pain;  malaise,  anorexia;  history  of  polymyalgia rheumatica
Temporal  arteritis
44
Fever,  weight  loss;  tender  over a  nodular  temporal  artery
Temporal  arteritis
45
DIAGNOSTIC STUDIES OF Temporal  arteritis?
Elevated  ESR  050); immediate  referral for  treatment
46
History  of  exposure;  throbbing headache,  mild  dyspnea
Carbon  monoxide poisoning
47
Nausea,  vomiting,  change  in mental  status,  lethargy,  loss of  consciousness
Carbon  monoxide poisoning
48
DIAGNOSTIC STUDIES OF Carbon  monoxide poisoning?
Blood  gases  and carboxyhemoglobin level
49
History  of  diabetes  or  medication, alcohol,  and  food  ingestion;  generalized  headache,  dizziness, sense  of  not  feeling  well
Severe  hypoglycemia
50
Normal  physical  examination or  pallor,  sweating,  and weakness
Severe  hypoglycemia
51
DIAGNOSTIC STUDIES OF Severe  hypoglycemia?
Blood  glucose  level;  may need  self-monitoring of  blood  glucose  to establish  pattern
52
Pattern  of  headache  associated with  stopping  medication  or substance  use
Drug  withdrawal
53
Normal  physical  examination
Drug  withdrawal
54
DIAGNOSTIC STUDIES OF Drug  withdrawal?
Blood  chemistry
55
Mild to moderately severe headache after ingestion of foods or medication
Dietary ingestion
56
Normal physical examination
Dietary ingestion
57
DIAGNOSTIC STUDIES OF Dietary ingestion?
Blood chemistry
58
Sudden-onset headache that is progressive, exacerbated by coughing or exercise; worse in morning; history of trauma increases risk
Intracranial tumor
59
Papilledema, vomiting, asymmetrical reflexes, weakness, sensory deficit, or other neurological deficit
Intracranial tumor
60
DIAGNOSTIC STUDIES OF Intracranial tumor?
CT scan
61
Progressive headache, vomiting, irritability
Hydrocephalus
62
Rapid enlargement of head, bulging fontanels
Hydrocephalus
63
DIAGNOSTIC STUDIES OF Hydrocephalus?
CT scan and referral
64
History of head trauma, bleeding disorders, child abuse-, adult >35 yr; sudden onset of “worst headache ever,” often over eye; transient loss of consciousness
Subdural hematoma
65
Unequal pupils, photophobia, neurological changes, seizure
Subdural hematoma
66
DIAGNOSTIC STUDIES OF Subdural hematoma?
CT scan and neurosurgical referral
67
Teens, menopausal women; history of vitamin A or tetracycline ingestion; progressive headache  
Pseudotumor cerebri
68
Papilledema may be present
Pseudotumor cerebri
69
DIAGNOSTIC STUDIES OF Pseudotumor cerebri?
CT scan, neurology referral to assess risk related to lumbar puncture
70
History of chronic ear infection or cyanotic heart disease
Brain abscess
71
Fever, seizures, focal neurological deficits
Brain abscess
72
DIAGNOSTIC STUDIES OF Brain abscess?
MRI
73
Risk factors; people >50 yr, with AIDS, taking anticoagulation therapy, hypertension
Intracerebral hemorrhage
74
If conscious, abnormal neurological findings correlated with extent of lesion
Intracerebral hemorrhage
75
DIAGNOSTIC STUDIES OF Intracerebral hemorrhage?
Emergency transport for immediate evaluation (CT, MRI and possible surgical treatment)

Physical Assessment (27 decks)

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