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Revesion > headach > Flashcards

headach Flashcards

1
Q

what is the pattern of tension type headach?

A

no vomiting + 2 of :
not pulsatile
bilateral
mild-modrate
not exacerbate by activity

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2
Q

what is the dignostic criteria for migrain ?

A

4-72 hours +2
- pulsating
-unilateral
-disabling
- modrate to sever pain

during attack : +1
N/V
phobia

$no other explanitin
$at least 5 attack fit to criteria

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3
Q

what is the dignostic criteria for migrain ?

A

4-72 hours +2
- pulsating
-unilateral
-disabling
- modrate to sever pain

during attack : +1
N/V
phobia

$no other explanitin
$at least 5 attack fit to criteria

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4
Q

pattern of cluster type headach ?

A

unilateral on eye ot around it +1 :
- red eye
-rhinorrhea
-forhead diaphoresis
-ptosis or constrict pupile

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5
Q

how to remember migrain characteristic symptoms ?

A

POUND mnemonic :
Pulsatile pain for 4-72 HOur Unilateral with nusa
Disabling for Pt .

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6
Q

headach red flag ?

A

SNNOOP:
-systemic symptom (fever HTN )
-neurological symptome
-neoplasm
-onset suudenly like thunder
-older age > 50
-Post traumatic
-Pregnant
-Papilledema
-Pattern chang / Progressive

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7
Q

headach red flag ?

A

SNNOOP:
-systemic symptom (fever HTN )
-neurological symptome
-neoplasm
-onset suudenly like thunder
-older age > 50
-Post traumatic
-Pregnant
-Papilledema
-Pattern chang / Progressive

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8
Q

what is the difference between TIA and migrain regarding visual ?

A

migraine : gradual and it sho aura like zigzag pattern
TIA : sudden visual lose

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9
Q

pharmacological Rx for cluster headach ?

A

pain : triptan + O2 100%
prophylaxis : verpamile , lithium

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10
Q

next step in PT present with thunderclap headach ?

A

CT scan during 12 hours maximum
LP follow CT scan result

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11
Q

best modality to investigate secondary cause of headach ?

A

MRI except in emergency

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12
Q

what is think frame in headach approch ?

A

start to role out secondary cause and red flag
then assist for primary cause mange regard that

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13
Q

first line treatment for migraine ?

A

paracetamol + NSAID
+ triptans

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14
Q

which NSAIDs are better and relief pain in migraine?

A

same no difference

(tip: naproxen slower onset + longer half life)

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15
Q

how to chose from first line ?

A

many strategies:
1- regarding severity
para+NSAIDs for mild to modret
triptans for moderate to sever

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16
Q

how to chose from first line ?

A

many strategies:
1- regarding severity
para+NSAIDs for mild to modret
triptans for moderate to sever

17
Q

best triptan medication to relived pain in 2 hours ?

A

sumatriptan 6mg subcutaneous injection .

18
Q

sumatriptan dosing ?

A

25-50-100 mg formula
u can repete the dose evry 2 hour maximum dose 200mg/day

for subcutaneous injection 6mg u can repete the dose after 1 hour maximum dose 12 mg/day

19
Q

mangment of acute migrain attack on ER :

A

-antiemetic (metoclpramide )
-hydration
-oxygen
-triptane injection

20
Q

refractory migraine

A

paraintral dihydroergotamine

21
Q

migrain in pregnant :

A

only save established is :
paracetamol and metoclopramide

22
Q

what is the trigger of migrain headach ?

A

food&drink :
-caffine
-alchole
-chocolate and cheesses
(missing meal)

life style :
Sleep Smoke Stress exerciSe

light , menses

23
Q

when to start prophylaxis ?

A

=> 4 attack /month
-non tolrating an acute therapy
-overuse of medication
-deblilting attack despite acute therapy

Pt preference

24
Q

when to consider prophylaxis mangment good ?

A

if attack reduced by 50%
(goal)

25
Q

how to start a prophylaxis - starting dose and when to titrate ?

A

start with lowest dose then titrate every 4 week if there is no adequate response .

26
Q

when to chang prophylaxis ?

A
  • if he not meet the goal for 6 month
  • not efective with
  • maximume dose
    adversed effecte .
27
Q

when to stop prophylaxis ?

A

if headaches are controlled for 12 month , slowly tapering .

28
Q

first line prophylaxis for migraine?

A

-beta blocker (metoprolol , propranolol timolol )
-anticonvulsant
(divalproex, topiramate)

(frovatriptan)

29
Q

best migraine Rx for menstrual related migraine ?

A

Frovatriptan

30
Q

prophylaxis for migrain in pregnant ?

A

propranolol consider save

Revesion (5 decks)

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