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Clin Med III Disease Key Notes > Head/Facial Disorders (Exam #3) > Flashcards

Head/Facial Disorders (Exam #3) Flashcards

1
Q

What condition involves acute CN VII palsy?

A

Bell’s Palsy

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2
Q

What is often the etiology of Bell’s Palsy? What are the two major RF associated with Bell’s Palsy?

A

IDIOPATHIC

- Consider DM, pregnancy

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3
Q

What condition involves sudden onset (hours) unilateral facial paralysis with inability to close eye, facial drooping with flattened nasolabial fold?

A

Bell’s Palsy

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4
Q

What three signs/sxs can be seen with Bell’s Palsy?

A
  • Unilateral facial paralysis with inability to close eye
  • Facial droop
  • Flattened nasolabial fold
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5
Q

How can you differentiate Bell’s Palsy from the two ddx of Lyme Disease and Guillain-Barre?

A
  • Bell’s Palsy = unilateral

- Lyme Disease and Guillain-Barre are BOTH bilateral

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6
Q

What is the preferred dx for Bell’s Palsy?

A

CLINICAL

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7
Q

What is the tx for ALL patients with Bell’s Palsy (2)? When is this best started?

A

Prednisone x7 days +/- Valacyclovir

- Best if started within 3 days of sxs onset

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8
Q

How can you differentiate a Peripheral Facial Palsy from a Central Facial Palsy (2)? What possible dx are associated with each?

A
  • Peripheral = Bell’s Palsy: LMN lesion affecting ipsilateral side; forehead affected
  • Central = stroke, tumor: UMN lesion affecting contralateral side; forehead spared
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9
Q

What side of the face is affected with Bell’s Palsy, and is the forehead affected or not?

A
  • Lesion affects ipsilateral side

- DOES involve forehead

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10
Q

What condition involves “tic doulaureux”: pain along CN V?

A

Trigeminal Neuralgia

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11
Q

What is a major RF associated with Trigeminal Neuralgia?

A

HTN

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12
Q

What condition involves episodes of severe shooting pain lasting a few seconds?

A

Trigeminal Neuralgia

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13
Q

What sign is commonly seen in patients with Trigeminal Neuralgia?

A

Guarding

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14
Q

Is Trigeminal Neuralgia usually unilateral or bilateral? What distributions are most affected (2)?

A

UNILATERAL

- V2 and V3

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15
Q

What three requirements must be met to diagnose Trigeminal Neuralgia?

A
  • 3+ episodes of unilateral facial attacks (shock-like/shooting)
  • CN V distribution ONLY
  • NO neuro deficits
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16
Q

What is the recommended tx for Trigeminal Neuralgia, and how is it often maintained/dosed?

A

Carbamazepine

- Increase gradually with typical maintenance dose of 600-800 mg/day

17
Q

When treating a patient with Carbamazepine for Trigeminal Neuralgia, what MUST be tested before initiating?

A

HLA-B 15:02 allele in Asian population

18
Q

What condition is often associated with Giant Cell Arteritis?

A

Polymyalgia Rheumatica (PMR)

19
Q

If blindness is seen with Giant Cell Arteritis, occlusion of what artery shoud be considered? What about if stroke/brainstem infarct is seen?

A
  • Blindness = Ophthalmic a. occlusion

- Stroke/brainstem infarct = Basilar a. occlusion

20
Q

What are the two most common sxs seen with Giant Cell Arteritis?

A
  • Jaw claudication

- New HA

21
Q

What condition can involve transient blindness, and what is the specific name for this?

A

Giant Cell Arteritis

- Amaurosis fugax

22
Q

What condition involves amaurosis fugax, and what is this?

A

Giant Cell Arteritis

- Transient blindness

23
Q

What condition involves transient blindness, PMR sxs, unexplained fever or other constitutional sxs (fatigue, weight loss)?

A

Giant Cell Arteritis

24
Q

How do you SCREEN for Giant Cell Arteritis? What will be seen?

A

ESR = elevated (50+)

25
Q

How do you DIAGNOSE Giant Cell Arteritis? What will be seen?

A

Temporal Artery Biopsy (TAB)

- Shows multi-nucleated cells

26
Q

How can you clinically dx Giant Cell Arteritis (5)?

A

3 of 5…

  • 50+ years
  • New/localized HA
  • Temporal a. tenderness
  • ESR of 50+
  • +TAB
27
Q

What are the two primary goals in tx of Giant Cell Arteritis?

A
  • Prevent blindness

- Prevent stroke

28
Q

What is the recommended tx for Giant Cell Arteritis?

A

HIGH-DOSE Prednisone

- Then taper (can be lifelong)

29
Q

What condition involves pain associated with TMJ misalignment?

What gender and age group is it most often seen?

A

TMJ Dysfunction

  • Female
  • 20-40 years
30
Q

What is a RF associated with TMJ Dysfunction?

A

RA

31
Q

What area of the head does pain present with TMJ Dysfunction (2)? Where might it radiate to (3)?

A

Periauricular pain of TMJ and mastication muscles

- Possible radiation to ear, temple, periorybital regions

32
Q

Which head condition involves crepitus with movement?

A

TMJ Dysfunction

33
Q

What two signs may be seen on PE for TMJ Dysfunction?

A
  • Jaw subluxation/dislocation (“catching” vs. “locking”)

- Decreased ROM

34
Q

What is the dx for TMJ Dysfunction?

A

CLINICAL

35
Q

What is the recommended tx for TMJ Dysfunction? What meds may be considered (3)?

A

Dental referral

  • Tylenol
  • NSAIDs
  • Muscle relaxants

Clin Med III Disease Key Notes (18 decks)

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