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Clin Med III Disease Key Notes > HA (Exam #3) > Flashcards

HA (Exam #3) Flashcards

1
Q

What are the four types of HA?

A
  • Vascular (migraine, cluster)
  • Muscle contraction (tension)
  • Traction)
  • Inflammatory
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2
Q

Which type of HA is the most common DIAGNOSIS given?

A

Migraine HA

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3
Q

Which type of HA involves unilateral throbbing, pulsating lasting 4-72 hours?

A

Migraine HA

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4
Q

Which type of HA involves “PIN”, and what does this stand for?

A

Migraine HA

  • Photophobia
  • Incapacitating
  • N/V
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5
Q

What type of HA involves allodynia?

A

Migraine HA

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6
Q

What does a “classic” migraine look like?

A

Migraine WITH aura

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7
Q

What does a “common” migraine look like?

A

Migraine WITHOUT aura

- PIN sxs; HA without warning, chronic recurring

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8
Q

What are the four phases of a “classic” migraine?

A
  1. Prodrome
  2. Aura
  3. HA
  4. Postdrome
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9
Q

What phase of a “classic” migraine presents as food cravings, mood change, yawning, fluid retention, constipation?

When does this present?

A

Prodrome

- 24-48 hours pre-HA

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10
Q

What phase of a “classic” migraine presents as +sxs (visual, auditory, sensory motor) and -sxs (loss of function, vision, hearing, sensation, motor)?

When does this present, and how long doe sit typically last?

A

AURA

  • 10-60 minutes pre-HA
  • Lasts 60 minutes
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11
Q

How do the actual HA sxs of a Migraine WITH Aura differ from a Migraine WITHOUT Aura?

A

BOTH: unilateral throbbing/pulsatile pain

  • WITH: N/V OR photophobia OR phonophobia
  • WITHOUT: PIN (photophobia, incapacitating, N/V); allodynia
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12
Q

When might a CT be ordered to evaluate a Migraine HA (4)?

A
  • “Worst HA of life”
  • Change in HA presentation
  • New/unexplained neuro sxs
  • Refractory
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13
Q

What is the first line treatment for a mild/moderate migraine HA (3)? Severe HA (2)?

A
  • Mild/moderate: NSAID, Acetaminophen, Excedrin

- Severe: Triptans, Ergots

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14
Q

What AE may be seen with the use of Triptans for Migraine HA?

A

“Triptan Sensation”

- Injection site rxn, CP/heaviness, flushing, weakness, drowsy

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15
Q

What AE is seen with both Triptans and Ergots? What is the main CI associated with these drugs?

A

VASOCONSTRICTION (dig deep to Pharm ppl)

- CI if pregnant

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16
Q

What three drugs can be considered for Migraine HA prophylaxis?

A
  • Propranolol (BB)
  • Amitriptyline (antidepressant)
  • Topiramate (anticonvulsant)
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17
Q

Which type of HA is the most COMMON HA?

A

Tension-Type HA (TTH)

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18
Q

Which type of HA involves bilateral pressure lasting 30 min. to 7 days?

A

Tension-Type HA (TTH)

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19
Q

Which type of HA involves “band-like” pressure?

A

Tension-Type HA (TTH)

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20
Q

Which type of HA is associated with anorexia, head/neck pain with muscle pain, bruxism?

A

Tension-Type HA (TTH)

21
Q

How are ALL HA diagnosed? Which two can also involve imaging, and what type of imaging is preferred?

A

CLINICAL

  • Migraine HA = CT
  • Cluster HA = MRI
22
Q

What is the main tx for Tension-Type HA (TTH)? What other tx is also recommended?

A

NSAIDs

- Also, tx underlying condition (jaw/mouth, sleep study, less stress)

23
Q

Which type of HA is the most DEBILITATING HA?

A

Cluster HA

24
Q

Which type of HA is more common in males than females?

A

Cluster HA

25
Q

Which type of HA involves excruciating unilateral sharp, boring periorbital HA lasting 15 min. to 2 hours?

A

Cluster HA

26
Q

What other sxs (besides pain in the head) are seen with Cluster HA?

A

Autonomic sxs

27
Q

What is the timeline for each type of HA?

A
  • Cluster = 15 min. to 2 hour
  • Migraine = 4-72 hours
  • Tension-Type = 30 min. to 7 days
28
Q

What is recommended for acute tx of Cluster HA (2)?

A
  • 100 O2 at 12+ L/min

- Sumatriptan given SC

29
Q

What is recommended for preventative tx of Cluster HA?

A

Verapamil (CCB)

30
Q

What type of HA involves 15+ days/month for 3+ months; moderate pain on sides/top of head?

A

Chronic Daily HA

31
Q

What type of HA involves continuous, fluctuating pain on same side of face/head lasting minutes/days?

A

Hemicrania Continua

32
Q

What is the recommended tx for Hemicrania Continua?

A

Indomethacin

33
Q

What type of HA involves abrupt onset & unremitting throbbing/tightening on both sides of head?

A

New Daily Persistent HA (NDPH)

34
Q

What is the recommended tx for New Daily Persistent HA (NDPH)?

A

Muscle relaxants

35
Q

What type of HA involves “ice pick” or “jabs and jolts”?

A

Primary Stabbing HA

36
Q

What type of HA involves sudden onset intense pain that strikes without warning lasting 1-10 seconds; often around eye?

A

Primary Stabbing HA

37
Q

What is the recommended tx for Primary Stabbing HA?

A

Indomethacin

38
Q

What type of HA involves triggered by cough, sneeze, intense activity; lasts minutes to days?

A

Primary Exertional HA

39
Q

What type of HA is also called the “alarm-clock” HA? What age group is it often seen?

A

Hypnic HA

- 50+ years (occurs late in life)

40
Q

What is the recommended dx test for Hypnic HA?

A

MRI

41
Q

What is the recommended tx for Hypnic HA? What med can also be considered?

A

Caffeine at night

- Indomethacin

42
Q

What type of HA occurs during sleep and awakens patient; throbbing on both sides of head?

A

Hypnic HA

43
Q

What two groups of meds can create increased risk for Medication Overuse HA (MOH)?

A
  • Opioids

- Barbs

44
Q

Secondary HA presenting with sxs worse with cough, exertion, straining, position is indicative of?

A

Pseudotumor cerebri

45
Q

Secondary HA presenting with sxs worse with steady/worsening + neuro sxs, nighttime awakenings is indicative of?

A

Brain tumor

46
Q

Secondary HA presenting with “thunderclap HA”, decreased LOC is indicative of?

A

SAH

47
Q

Secondary HA presenting with age 50+ years, throbbing temporal pain with TTP is indicative of?

A

Temporal Arteritis

48
Q

What is the tx for Medication Overuse HA (MOH)?

A

NSAIDs

- ASA and Acetaminophen can make it worse

Clin Med III Disease Key Notes (18 decks)

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