Final Exam -- Randomized Cards Part 2 Flashcards
Comparing angina and myocardial infarction, which is relieved by rest and/or nitroglycerin and is usually of short duration?
Angina
What is the treatment for a viral sinus headache?
Observation, NSAIDs, saline irrigation, degongestants.
Over the counter acute therapy for migraines involves NSAIDs or acetominophen, or Excedrin (combination of acetominophen, caffeine, and aspirin). True or false: a large single dose is more e
True.
Headache is the initial complaint in 20% of patients with what condition?
Brain tumor.
Headache danger signs are symptoms which may indicate a serious underlying cause of the headache. These can be remembered by the acronym SNOOP. What does the S stand for?
Systemic symptoms–fever, weight loss, cancer, immunocompromised, pregnant
Nearly 90% of headaches fall into one of these categories: migraine, tension-type, chronic daily, and cluster. Which of these types of the most commonly diagnosed?
Migraine
What type of migraine subtype is associated with unilateral weakness during the headache?
Hemiplegic migraine
Prevention of migraines can be done with a calcium channel blocker like _________ .
Verpamil
What are some of the symptoms in a patient with a brain tumor?
N&V, seizures, focal weakness, headache, changes in personality, visual changes.
Retinal migraine (aka ocular or ophthalmic migraine*) is thought to involve which arteries?
Central retinal and ophthalmic
Tension headaches are divided into infrequent/episodic, frequent, and chronic. On average, how often do infrequent/episodic headaches occur?
Less than 1 day per month on average
What do you do for a patient that is experiencing angina or a myocardial infarction?
Call 911 and administer a single chewed 325 mg dose of aspirin (and 0.4 mg sublingual nitroglycerin if the patient uses it for angina). Monitor their vitals.
How would you treat a mild to moderate acute migraine?
NSAIDs or acetominophen
Which migraine subtype involves the brainstem or bilateral occipital hemispheres?
Migraine with brainstem aura (aka basilar migraine)
What are some of the symptoms of anaphylaxis?
Shakiness, nervousness/anxiety, sweating, chills, clamminess, irritability or impatience, rapid heartbeat, lightheadedness/dizziness, hunger and nausea, sleepiness, headaches, weakness or fatigue, lack of coordination.
True or false: with basilar migraine, it is possible for a patient to have weakness
False; there should be no evidence of weakness.
How would you treat giant cell arteritis?
IV methylprednisolon if vision loss is present, and oral prednisone, and low dose aspirin.
Trigeminal autonomic cephalgias are thought to be due to abnormal hypothalamus and trigeminal activity.
Free card.
Comparing angina and myocardial infarction, which is not relieved by rest or nitroglycerin and can last hours?
Myocardial infarction.
Trigeminal neuralgia episodes last how long? Which branches of the trigeminal nerve are most commonly affected?
Episodes last a few seconds to 2 minutes; V2 and/or V3 are most commonly affected
True or false: when using triptans to treat an acute migraine, they should be taken early on, but not more than 3 times per week*
True.
What drug can be used to treat trigeminal neuralgia?
Carbamazepine*
What are some of the acute treatment options for cluster headaches?
100% oxygen therapy, subcutaneous or nasal sumatriptan
True or false: a retinal migraine is associated with a severe headache and can lead to permanent vision loss.
False; it can indeed lead to permanent vision loss, but the associated headach is mild*
To be diagnosed as migraine with aura, the aura symptom(s) must be fully reversible. Two of what four characteristics must be present?
At least one aura symptoms spreading gradually over more than 5 minutes (and/or two or more symptoms occurring in succession); individual aura symptoms last 5 to 60 minutes; at least one aura symptom is unilateral; aura accompanied by or followed within 60 minutes by a headache
Comparing migraine with aura to migraine without aura, which requires at least two attacks for diagnosis?
Migraine with aura
What are the most common primary intracranial tumors?
Meningiomas, gliomas, pituitary adenomas
If a patient experiences syncope, what would be a few reasons to call 911?
Irregular heartbeat, chest pain or SOB, more than one episode a month, no response to ammonia inhalant, or if the fainting occurred due to head turning.
What is the treatment for an anaphylactic shock?
Administer subcutaneous epinephrine, call 911, give them benadryl if they can swallow it. Also have them lie flat, raise feet about 12 inches, and cover with a blanket to prevent shock.
Triptans are used to treat acute migraines and are agonists of __________.
Serotonin
What type of headache is commonly misdiagnosed as due to sinusitis?
Migraine
True or false: thunderclap headaches recur regularly and can be unilateral or bilateral.
False; they can indeed be unilateral or bilateral, but they do NOT recur regularly.
Comparing tension headaches to migraines, which does worsen with exercise?
Migraine
What are some of the symptoms of a cardiovascular accident or a transient ischemic attack?
Sudden onset of: Numbness or weakness or face/arm/leg, especially on one side of bodyConfusion, trouble speaking or understandingTrouble seeing or blurred vision in one or both eyesTrouble walking, dizziness, loss of balance or coordinationSevere headache with no cause
What are the risk factors for postherpetic neuralgia?
Older age, severity of initial rash and pain, and immunocompromised
What is the treatment for a bacterial sinus headache?
Augmentin
The diagnostic criteria for a migraine without aura includes the headache lasting how long?
4 to 72 hours
What are some of the early signs of diabetic ketoacidosis?
Thirst or dry mouth, frequent urination, high blood glucose, high level of ketones in urine.
Migraines are associated with depletion of which endogenous substances? With excess of which substance?
Depletion of serotonin and estrogen; excess dopamine.
What do you do if your patient is experiencing diabetic ketoacidosis?
Measure their blood glucose, administer insulin, and keep them hydrated (and correct the electrolyte disturbances), and call 911 or take them to the hospital.
What are some of the signs of anaphylaxis?
Skin reaction, hives, flushed or pale skin, feeling of warmth, sensation of a lump in the throat, constriction of airways, swollen tongue or throat, weak and rapid pulse, N&V, dizziness or fainting, reduced blood pressure.
What is the chronic treatment for SUNCT?
Lamotrigine, occipital nerve stimulation
Your patient has experienced a seizure. What do you do after the seizure?
Lay them on their side to keep the airway clear (Recovery Position) and make sure they are still breathing.
Treatment for tension headaches can include analgesics (ibuprofen, naproxen, aspirin) and acetaminophen. Which of these (analgesics vs acetaminophen) is less effective and should be limited in use to 9 days/month and limited to 2 doses/day?
Acetaminophen
Which headaches discussed in class are more common in men?
Cluster headachesSUNCT
True or false: the cortical spreading depression theory (CSD) states that nociceptor threshold is increased, and the magnitude of their response is increased as well.
False; the threshold is decreased (easier to feel pain), and the magnitude is increased
Your patient is experiencing a seizure. What do you do during the seizure?
Move dangerous items away from the individuals, but don’t try to hold them down or put anything in their mouth. Record the length of the seizure.
In order to diagnose a tension headache, there must be at least 10 episodes of headaches fulfilling four other criteria. One of them is there must be at least two of which four characteristics?
BilateralPressing/tightning (nonpulsating)Mild/moderate intensityNot aggravated by routine physical activity
How would you treat an extremely severe acute migraine?
Subcutaneous sumatriptan, IV/I antiemetic with diphenhydramine or dihydroergotamine, IV/IM ketorolac or dexamethasone
True or false: narcotics and opioids are good treatment options for acute migraines.
False; they are not recommended.
What visual symptom occurs with a retinal migraine, and how long does it typically last?
Monocular scotoma or blindness*Lasts from minutes to less than an hour
The pain of postherpetic neuralgia is ___________ (unilateral/bilateral), sharp/stabbing, and affects which branch(es) of the trigeminal nerve?
V1*
Avoiding triggers of migraines, getting regular sleep, regular meals, and regular exercise, and keeping a headache diary can all help with migraine management. What two other options were listed in lecture?
Acupuncture and transcutaneous electric nerve stimulation (TENS)
Comparing angina and myocardial infarction, which involves a completely stoppage of blood flow to the heart?
Myocardial infarction.
The motor aura that occurs in hemiplegic migraines contrasts with the aura of basilar migraines in that the hemiplegic migraine auras last how long?
1 to 24 hours
Besides triptan treatment for acute migraines, you can use a triptan/NSAID combo, or dihydroergotamine.
Free card.
The headaches that occur in recurrent painful ophthalmoplegic neuropathy can develop up to how many weeks prior to the eye muscle weakness? Does the eye muscle weakness ever resolve?
2 weeks; the muscle weakness does recover completely between attacks.
One possible cause for hypoglycemia is if the patient skips a meal. What level of blood sugar may indicate hypoglycemia?
Less than 70 mg/dL
The most common type of aura is visual. It occurs over 5 minutes and may be a zig-zag pattern or a shimmering scintillating appearance. It may be a C-shape and will leavea a central scotoma
Free card.
Comparing tension headaches to migraines, which is not typically associated with nausea or vomiting?
Tension