Fits, faints and funny turns Flashcards
What examinations should you perform on someone who presents with a headache?
Full neurological exam Fundoscopy Meningism assessment Basic obs - temp and BP Systems review
What investigations should you order for someone with a headache?
CT or MRI head
ESR, bloods, LP
What are primary headaches?
Headaches with no underlying cause
List types of primary headaches
Migraine
Tension type
Cluster
What are secondary headaches?
Headaches with a cause
List types of secondary headaches
Head and neck trauma Vascular disorder CNS infection ICP disorder Metabolic disorder Drug withdrawal Dental / ENT
List headache red flags
> 50
Abrupt / severe onset
Progressively severe / increasing frequency
Change in type of headache
Meningism / focal signs /confusion / LOC
FLAWS
Worse when lying down / valsalva / coughing
Cancer / HIV / preg / head injury
What 1 Sx can SAH present with alone?
Severe headache
What does a CT show in SAH under 12 hours?
Hyperdense blood in sulcus
What does CT show in SAH past 12 hours?
Potentially nothing - blood broken down
How can you detect a SAH after 12 hours?
LP showing xanthochromia
What do you need to ask of someone presenting with diplopia (double vision)?
Onset Character - horizontal / vertical Duration - only when reading / waking up? Pain Triggers
How do the presentations of Horners and CN3 palsy differ?
Horners = PARTIAL ptosis, miosis and anhydrosis
CN3 palsy = FULL ptosis
What is myasthenia gravis?
NMJ fatiguability
What are symptoms of MG?
Dysarthria and intermittent diplopia
What investigations must you do for someone presenting with fainting?
ECG Lying and standing BP 24hr telemetry Echo Loop recorder CT head
What does third degree heart block look like on ECG?
No relationship between P and QRS
