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NMSP Exam 2 > [CLMD] Headache [Hon] > Flashcards

[CLMD] Headache [Hon] Flashcards

1
Q

What are the two general categories of headaches?

A

Primary headaches (benign HA disorders)

Secondary headaches (HA sign of organic disease)

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2
Q

What is important to aquire during a history of headaches?

A

Pain

  • Intensity
  • Location
  • Duration
  • Impact of exertion

*NOT JUST THE WORST HEADACHES, all of the headaches the patient gets

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3
Q

What is contained in a prodrome?

A

Before onset of HA

  • Changes in energy levels
  • Fatigue
  • Muscle aches

-Aura

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4
Q

What are some unique associated symptoms with headaches?

A

N/V

Anorexia

Photophobia

Phonophobia

Dizziness

Ptosis/miosis

Watery eyes

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5
Q

What are common HA triggers?

A

Stress

Hormones

Diet

Enviornmental changes

Sensory stimuli

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6
Q

What are some of the worrisome signs associated with HA?

(pathoogical origin)

A
  • “Worst HA”
  • Onset of HA after age 50
  • Atypical HA for patient
  • HA with fever

-Abrupt onset

  • Subacute HA with progressive worsening over time
  • Drowsiness, confusion, memory impairment
  • Weakness
  • Abnormal neurological/medical exam
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7
Q

Define: Meningitis

A

Inflammation of the meninges surrounding brain and spinal cord, sometimes with associated encephalitis

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8
Q

What is the most common cause of bacterial meningitis in nearly all age groups?

A

Streptococcus pneumoniae

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9
Q

What is the most common cause of bacterial meningitis in the elderly?

A

Listeria monocytogenes

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10
Q

What is the most common cause of bacterial meningitis in teenagers and young adults?

A

Nisseria meningitidis

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11
Q

What is the most common cause of bacterial meningitis in unvaccinated children?

A

Hemophilus influenza

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12
Q

Symtpoms of meningitis?

A

Sudden high fever

Stiff neck

Severe HA

Confusion or difficulty concentrating

Seizures

Skin rash

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13
Q

How do you treat acute bacterial meningitis?

*TEST QUESTION*

A

IV steroids

  • Dexomethasone
  • Ceftriaxone
  • Vancomycin
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14
Q

Define encephalitis

A

The presence of an inflammatory process of the brain in association with clinical evidence of neurological dysfunction

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15
Q

What are the common causes of infectious encephalitis in an adult?

A

VIRUSES

  • HSV 1/2
  • HIV
  • West Nile
  • Varicella zoster
  • Treponema pallidum
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16
Q

What is the issue with the presentation of herpes simplex 1 encephalitis for diagnosis?

A

The clinical presentation is VERY SIMILAR to meningitis.

If you are unsure about the diagnosis, JUST ADD ACYCLOVIR (IV)

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17
Q

What type of encephalitis can mimic infectious encephalitis?

A

Autoimmune encephalitis

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18
Q

What are autoimmune encephalitis cases usually associated with?

A

SEIZURES

19
Q

What is important in the treatment of patients with autoimmune encephalitis?

A

INITIATION OF TREATMENT

While you are awaiting test results, best to have the treatment already initiated

20
Q

How do you treat autoimmune encephalitis?

A

High dose steroids

IVIg

Plasma exchange

Immunosuppresive agents

21
Q

What are the two known etiologies of autoimmune encephalitis?

A

NMDA encephalitis

LGI1 encephalitis

22
Q

NMDA Encephalitis

Gender?

Age?

Onset speed?

A

Gender = Women

Age = young/middle aged

Onset speed = rapid onset (less than 3 months)

23
Q

What are the clinical symptoms of NMDA encephalitis?

A

Abnormal psychiatric behavior

Speech dysfunction

Seizures

Movement disorder

Decreased level of consciousness

Central hypoventilation

24
Q

What are the abnormal lab results with NMDA encephalitis?

A

Abnormal EEG (extreme delta brush)

CSF (pleocytosis or oligoclonal bands)

25
Q

What is a common association with NMDA encephalitis?

A

Teratoma

26
Q

LGI1 Encephalitis

Gender?

A

Male

27
Q

What is the hallmark seizure associated with LGI1 encephalitis?

A

Faciobrachial dystonic seizures

28
Q

Describe what a faciobrachial dystonic seizure would look like

A

Brief seizures

Involve one side of the face, and the arm on the same side

Occurs frequently, hundreds of times per day

***DO NOT RESPOND TO ANTIEPILEPTIC DRUGS ALONG

29
Q

What is the general rule for imaging with a HA?

“Worrisome history”?

A

One-time thorough neuroimaging study

Urgent imaging study and L.P, possibly arteriogram

30
Q

Definition of:

Common migraine =

Classic migraine =

A

Common migraine = Migraine without aura

Classic migraine = Migraine with aura

31
Q

Migraine info not included in fc

A
32
Q

What is considered chronic migraine?

A

With HA 15 or more days per month, HA lasting 4 hours or longer

33
Q

What is the most widely discussed theory for migraine cause?

A

Neurogenic inflammation

34
Q

Typical location of tension type HA?

A

Bifrontal

Bioccipital

Neck

Shoulders

Band like

35
Q

Cluster HA

Intensity?

Association?

A

Intensity = SEVERE, EXCRUCIATING

Association = Obstructive sleep apnea

36
Q

Cluster HA

Location?

Unilateral/Bilateral?

A

Location = Orbitotemporal

Unilateral/Bilateral = ALWAYS UNILATERAL

37
Q

What is an excellent treatment for migraines?

A

Triptans

38
Q

What are the major contraindications to triptan use?

A

Cardiovascular disease

Raynauds

use with MAOIs or other 5HT1 agonists

39
Q

What do you go to for chronic migraine treatment if all other pharmacologic treatments dont work?

A

BOTOX injections

40
Q

What is trigeminal neuralgia?

A

Excruciating sharp, shooting, electrical quality pain

In the face

41
Q

Treatment for trigeminal neuralgia?

A

Carbamazepine

Oxcarbazepine

42
Q

What is SUNCT syndrome?

A

Shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing

43
Q

Paroxysmal hemicrania

Similar to?

Difference?

Responsive only to?

A

Similar to = cluster HA

Difference = shorter duration

Responsive only to= indomethacin

44
Q
A

NMSP Exam 2 (16 decks)

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