Headache

Question 1

What type of headache lasts 30 minutes to 7 days with pressure, non-pulsatile pain, is usually bilateral, and has no nausea or photophobia?

Answer 1

Tension- type headache

Question 2

What type of headache occurs daily, occurs at characteristic times of the year, usually 1h into sleep, located behind EYE, and occurs more often in men?

Answer 2

Cluster headache
Tx: lithium PROPHYLACTIC, CCB PROPHYLACTIC
HIGH FLOW OXYGEN

Question 3

Describe a Migraine with aura headache

Answer 3

Aura
unusual fatigue, nervousness, GI upset, visual or olfactory alteration
Aura should not last > 1hr or further investigation should occur
Sensory or visual aura

Question 4

Describe a Migraine without aura

Answer 4

4-72 hours lasting
usually unilateral 
pulsating in quality
may be moderate to severe in intensity 
may have >/= 1 of the following: nausea, vomiting, photophobia, phonophobia

Migraine specific TX: triptans, migrana, take at onset of headache

Question 5

In which case should you not give Triptan medications or Ergot derivatives?

Answer 5

CVD, HTN (poorly controlled), or CVA

Question 6

What natural medications can you use for prevention of migraine?

Answer 6

magnesium
butterburr
feverfew

Question 7

Which medication is inappropriate for a patient with migraine with aura? Think birth control

Answer 7

Estrogen based birth control such as
combined estrogen-progestin oral contraceptive

Options: copper iud, Levonorgesterel, Progestin-only implant

Question 8

Which of the following medications is preventative and which is prophylactic for migraine?

Ergotamine
Verapamil
Propranolol
Rizatriptan

Answer 8

Ergotamine and Rizatriptan = abortive / take at onset

Verapamil and Propanolol = prophylactic