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OTC > Exam 3 - Headaches, Drowsiness, and Fatigue > Flashcards

Exam 3 - Headaches, Drowsiness, and Fatigue Flashcards

1
Q

Are migraines or tension headaches more common

A

Tension headaches

Migraine: 1.04 billion
Tension: 1.89 billion

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1
Q

Headache epidemiology

A
  • headache disorders are the most common disorder of the nervous system
  • associated with pain, disability, and decreased quality of life
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2
Q

What demographics are headaches more common in

A

Women and younger populations

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3
Q

Headache statistics (prevalence)

A
  • 50% of the world’s adult population has experience HA within the past year
  • 5th most common reason for ED visit and accounts for ~3% of all ED visits
  • 1 in 6 Americans report severe HA within past 3 months
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4
Q

Health disparities include issues involved in:

A

Incidence
Prevalence
Migraine-related pain disability
Access to care
Quality of care

(IMPAQ)

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5
Q

What are primary headaches

A

Headaches that are NOT associated with an underlying illness

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5
Q

HA health disparities affected groups

A

American Indians
African Americans
Hispanics

Poverty
Unemployed/underemployed
Uninsured/underinsured

People exposed to stress across an extended time period

People experiencing more than one of the above

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6
Q

What are medication overuse headaches considered

A

Secondary

(Stressed this in class — makes sense because it has a direct cause)

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7
Q

What percentage of HAs are primary HAs

A

~90%

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7
Q

Examples of primary headaches

A

Episodic and chronic tension HA
Migraine (with/without aura)
Cluster HAs

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8
Q

What are secondary HAs

A

Symptomatic of an underlying condition such as:

Trauma
Stroke
Substance use/withdrawal
Bacterial and viral diseases
Craniofacial disorders

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9
Q

Lifestyle modifications

A
  • Stress management
  • Cognitive therapy
  • Maintaining schedules for: sleep, exercise, and eating
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9
Q

Types of headaches for self treatment

A

Tension
Migraines
Sinus (simple/minor)

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10
Q

Patient education for HA

A

Types of headaches/diagnosis
Safe medication use
Lifestyle modifications

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10
Q

HA treatment goals

A
  1. Alleviate acute pain
  2. Restore normal functioning
  3. Prevent relapse
  4. Minimize adverse effects
  5. Reduce frequency of headaches (for chronic)
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11
Q

_______ has shown evidence in helping headaches

A

Acupuncture

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12
Q

What should be included in a HA diary

A

Related symptoms
Duration
Frequency
Triggers
Medications that did/didn’t work
Menstruation

***keep for at least 8 weeks

(Really Down For The Moment, Man)

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13
Q

Nonpharmacologic therapy for headache

A

Pt education
Acupuncture
HA diary

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13
Q

Pressure points for HA relief

A

Daith ear piercing
Acupuncture in ear

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14
Q

Tension headache pathophysiology

A
  • Response to stress, anxiety, depression, emotional conflict
  • Mechanisms are not fully understood
  • Genetic and environmental factors involved
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15
Q

The mechanisms of tension HAs are not fully understood. What are they thought to be related to?

A

Increased sensitivity of central and peripheral pain receptors

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16
Q

What determines if tension headaches are chronic

A

Occur 15+ DAYS per month for at least 3 months

*Stressed that it is measured in days, not # of HAs

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17
Q

What determines if tension headaches are episodic

A

Occur LESS THAN 15 days per month

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18
Q

What determines if HAs are FREQUENT episodic

A

10+ episodes per month

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19
What determines if HAs are INFREQUENT episodic
1 or fewer episodes per month on average
20
When do tension headaches typically begin
Usually during teenage years Women are more likely to be affected (3:2)
21
Tension HA location
Bilateral
22
Tension HA Nature
Diffuse HA Tightening Pressing Constricting Non-pulsating
23
Tension HA Duration
30 min - 7 days
24
Tension HA Aggravating factors
Stress Anxiety
25
Tension HA Intensity
Mild-moderate
26
Tension HA Onset
Gradual
27
Tension HA Other symptoms
Scalp tenderness Neck pain Muscle tension Photo OR phonophobia (Sore Neck Muscles, Probably)
28
Treatment of episodic tension HAs
Analgesics Nonpharmacologic treatment Combination therapy
29
Analgesics for treatment of episodic tension HAs
Aspirin (Bayer) OTC and Rx options NSAIDs: - ibuprofen (advil, motrin) - naproxen (aleve)
30
What is the max self care duration for episodic tension HAs? What is the reason for this max?
3 days per week or 15 days per month Max exists to prevent medication overuse/chronic tension HA
31
Nonpharmacologic treatment for episodic tension HAs
Correct posture Relaxation techniques Alternative medicine Physical therapy (CRAP)
32
Alternative medicine for treatment of episodic tension HAs
Acupuncture Massage Deep breathing/behavioral therapy
33
Combination therapies for treatment of episodic tension HAs
Combo of aspirin, APAP, ibuprofen, and caffeine This is more effective than just APAP
34
Maximum self care use of combination therapies for treatment of episodic tension HAs
10 days/month
35
Which of the following is a symptom of a tension-type headache Unilateral pain Nausea Sharp pain Pressure wrapping around the head
Pressure wrapping around the head
36
To qualify as a migraine (withOUT aura), what characteristics must be present
At least two of the following: - Unilateral - Moderate to severe head pain - Pulsating - Aggravation by routine physical activity At least one of the following: - Photophobia/phonophobia - Nausea/vomiting
37
Before a migraine can be self treated, what must the patient have
Medical diagnosis of migraines
38
Migraine WITH aura
Patients experience neurologic signs/symptoms that precede or coincide w/ the onset of head pain and then resolve fully
39
Neurologic manifestations of migraines WITH aura
- Ocular perceptions of shimmering/flashing areas or blind spots - Difficulty speaking (rare) - Visual and auditory hallucinations - Muscle weakness (usually one sided) (Our Damn Vicious Migraines)
40
How long can neurologic symptoms of migraines WITH aura last
Neurologic symptoms may last up to 60 minutes Subsequent head pain lasting hours-days
41
When is a migraine considered to have aura
In patients with or without headache if neurologic symptom: - develops slowly over 5 min - lasts 5-60 min - resolves completely
41
For migraines WITH aura, head pain does NOT ________
Have to follow aura signs
42
If a patient is having a migraine, how might they describe the pain
As being one side of the head (unilateral)
43
phases of a migraine in order
Prodrome Aura Headache Postdrome (Pretty Awful Headaches, Pal)
44
Prodrome/premonitory
Pre-headache Can being hours to days before headache One or more signs occurring before clinical onset of migraine (ie head pains)
45
Prodrome/postdrome signs
Food cravings Yawning Neck pain/stiffness Hyperactivity/hypoactivity Fatigue Depression (Fuck Your New Hoe For Days)
45
Aura
No headache pain Usually evolves over 5 minutes and lasts 60 min Does not have to occur with every headache
46
Postdrome
Recovery period/migraine hangover Not experienced by everyone One or more signs occurring after the migraine episode (after pain is fading or gone)
46
Headache
Lasts several hours to days Pain levels vary Pain can shift from one side of the head to the other
47
Migraine triggers
Dehydration Hormonal changes Miscellaneous Environmental Food/diet (Don’t Have Migraines Every Friday)
48
Migraine triggers: dehydration
- major cause - address dehydration for all patients, especially children
49
Migraine triggers: Hormonal changes
- menopause and menstruation - medications such as hormonal contraceptives/other hormone therapies
50
Migraine triggers: Food/diet
- MSG - Nitrates (cured meats) - Caffeine/caffeine withdrawal - Saccharin/aspartame (phenylalanine) - Fermented/pickled foods - Alcohol - Chocolate (theobromines) - Tyramine (red wine, aged cheeses - Skipping meals/ low blood sugar (Might Not Catch Straight FACTS)
51
Migraine triggers: Environmental
- Fumes/odors (cleaning solution, paints, gas) - Tobacco smoke - Noises - Fragrances - Allergies - Weather changes - Bright lights - High altitudes (Fuck Those New Fake Ass Wanna Be Hoes)
52
Migraine triggers: Miscellaneous
Sleep deprivation or excess Head trauma Anxiety Physical exertion Eye strain Stress/post stress (most common) (SHAPES)
52
Preventative treatments for migraines
Daily therapy to reduce frequency, severity, and duration Patients w/ frequent HA may need both preventative and acute therapies NOT self treatments (require rx)
53
Preemptive care for migraines
Used when known trigger exists Ex. Menstruation
53
Acute care for migraines
Medications may be taken during the attack Used to relieve pain and stop progression May be best treatment plan in HA are infrequent, pt is non-compliant, or preventative treatment is not tolerated

OTC (31 decks)

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