Diff Di Lab Final Flashcards
How is Serotonin related to photophobia and Phonophobia for patients with migraines?
Serotonin is related to photophonia and phonophobia for patients with margarines because low levels of central serotonin decreases the threshold for stimulus making normal stimulus become painful.
What differentiates migraines from tension-type headaches?
The differences between migraines and tension-type headaches are that migraines would typically present as a pulsatile/pounding debilitating headache that is unilateral, lasts about 4-72 hours, and associated with nausea. While tension-type headaches tend to be non-pulsatile, non-pounding, bilateral in the temporal or suboccipital area headaches that last for days or longer.
What theoretically causes a migraine aura?
The hypothetical cause of a migraine aura is a spreading wave of cortical depression which is the result of hyper-polarization that results in decreased neuronal activity. This normally starts in the occipital lobe, which is why patients typically describe auras as visual.
What hypothetically is the structural connection to CN5 in the Csp. (Describe the antatomical overlap in location)
The structural connection between the trigeminal nerve and cervical spine is called the Trigemino-cervical nucleus. This is where the spinal nucleus of the trigeminal nerve inter locks with the dorsal horn of C1 through C3.
What lab tests are indicated for the diagnosis of Temporal Arteritis?
The two lab tests that indicate that a patient has Temporal Arteritis are elevated ESR and C-reactive protein.
What is the treatment for Temporal Arteritis? Why is it necessary?
Temporal Arteritis is treated with a strong anti-inflammatory corticosteroids. This is necessary because this is an inflammatory process of blood vessels that may lead to blindness, and damage vessels in the retina.
A 60 year old female complains for spinning dizziness when Turning her head to the right. There is no history of trauma and the attacks are brief.
What is the MOST LIKELY cause of her complaint and disorder?
What is the test used for this disorder?
What is the response you would expect? (4 responses to this disorder)
This case presentation is most likely due to BBPV. (Benign paroxysmal positional vertigo) BBPV is caused by floating debris of otoconia crystals in the semicircular canals.
The test used for BPPV is the Dix-Hallpike Maneuver.
The response we would expect for canalithiasis is a latency of about 20-40 seconds, a sudden onset of vertigo and nystagmus which will adapt if the patient is left in the position, and will fatigue if you repeat the maneuver multiple times.
What is the theoretical cause of Meniere’s Disease that relates to management approaches?
The hypothetical cause of Meniere’s is an increase in endo lymph that may be due to an overproduction or decrease in drainage of the endo lymph. This is related to treatment because the two common treatments include diuretics to decrease fluid and decreasing salt intake to decrease fluid retention.
Describe a classic presentation of a patient with Meniere’s?
A patient with Meniere’s would classically present with a complaint of fullness in the ear, sudden onset of vertigo which is associated with low tone tinnitus or hearing loss that typically lasts an hour to a day.
Describe 2 ways in which diabetes can cause a patient to complain of dizziness, and what test findings would confirm those two conditions.
The two ways that dizziness can be reported by a patient with diabetes are: the feeling of light headedness from standing up quickly which would be from orthostatic hypotension. This can be diagnosed by testing the patient’s blood pressure when lying, standings, and 2 minutes later to determine if there is a drop in systolic blood pressure.
The other way dizziness is typically reported if by the patient being “Off balance” from lass of proprioception which can be tested with Romberg’s Test. The patient is tested by standing with their feet together with their eyes open, and then with eyes closed. A positive is if the patient looses there balance or feels dizzy with their eyes closed.
Name the 2 most common cause of a complaint of being “off balanced”
The 2 most common causes of a complaint of being “Off balance” are diabetes or myelopathy due to central canal stenosis.
Name the 2 most common causes of a complaint of lightheadedness upon standing.
The two most common causes of a complaint of “light headedness upon standing” are diabetes and medications such as anti-hypertensives.
What in-office test can you perform to detect Alzheimer’s (Name 3 general components)?
The in-office screening tests to detect Alzheimer’s are Mini mental state exam which is composed of sections that test for orientation, abstract thinking, memory and drawing something. The other test that can be performed is the Mini Cog Exam which is testing people for recognizing and remembering three objects coupled with drawing a clock.
What is the difference in presentations between multiple infarct dementia and Alzheimer’s?
The differences in presentations between multiple infarct dementia and Alzheimer’s are that with multiple infarct dementia classically present with a sudden, rapid onset of memory loss associated with motor and or sensory deficits. Meanwhile patients with Alzheimer’s classically present with no motor or sensory deficits and it is a slow and progressive memory loss.
What are the 2 most sensitive historical clues for depression? List the cluster of physical complaints that depressed individuals often have when the somatize?
The most sensitive historical clues for depression are a feeling of depression or feeling of blue for more that 2 weeks coupled with anhedonia which is a loss of enjoyment in life.
The cluster of physical complaints that depressed individuals often have when they somatize include: multiple musculoskeletal complaints often times back pain, persistent mild headaches and dizziness, and difficulty breathing that is not painful and described as a pressure sensation in the chest.
