[headache] Flashcards
1
Q
A
meningeal irritation
2
Q
A
Meningitis
Encephalitis
SAH
3
Q
A
Encephalitis
4
Q
A
Odd behaviour
reduced consciousness
fits
5
Q
A
Meningitis
6
Q
A
Occipital (often, not always)
7
Q
A
Urgent CT
(SAH presents with meningeal irritation)
8
Q
A
LP
(infection or blood products in CSF)
9
Q
A
Subdural haematoma
Extradural haematoma
10
Q
A
CT
11
Q
A
Subdural haematoma
extra-dural haematoma
12
Q
A
Venous sinus thrombosis
13
Q
A
dull constant ache
14
Q
A
frontal sinuses
maxillary sinuses
15
Q
A
Rhinoviruses
16
Q
A
Common cold
17
Q
A
Low pressure CSF (leakage)
18
Q
A
acute glaucoma
19
Q
A
Acute glaucoma
20
Q
A
IV Acetazolamide
(pilocarpine)
21
Q
A
M3 muscle-r agonist. Causes cilliary contraction. Increases outflow of aqueous humour.
22
Q
A
Carbonic anhydrase-i
Decreases secretion of aqueous humour
23
Q
A
sudden onset
24
Q
A
worst ever headache
25
[Headache]: How will the pupil respond to light in acute glaucoma
Dilated and unresponsive
26
[Headache]: a red and congested eye indicates what headache causing phenomenon
acute glaucoma
27
[Headache]: What are the 3 causes of a chronic headache
Medication overuse
(aka analgesic rebound headache)
Tension headache
Raised ICP
28
[Headache]: What actions may worsen a raised ICP headache
Coughing
Bending over
on waking
29
[Headache]: Papilloedema may be observed in raised ICP T/F
T
30
[Headache]: What is the 1st Ix if raised ICP suspected
imaging to look for space occupying lesion (CT)
31
[Headache]: When would you do LP in a raised ICP patient
AFTER imaging
32
[Headache]: raised ICP may present with what 4 signs
Odd behaviour
Papilloedema
seizures
vomiting
33
[Headache]: How does a tension headache characteristically present
Bilateral non-pulsatile headache
(not affected by head movement)
34
[Headache]: What is the commonest reason for an episodic headache becoming chronis
analgesic overuse (esp. mixed analgesics)
35
[Headache]: in analgesic rebound headaches how many days should you limit the pt to over the counter medications
6days/month
36
[Headache]: Tx for tension headache
stress relief
37
[Headache]: is vomiting a feature of tension headaches
no
38
[Headache]: What 4 headaches can cause recurrent attacks of acute headaches
Migraine
Cluster headache
Trigeminal neuralgia
Recurrent meningitis (Mollarets)
39
[Headache]: what would make you suspect Mollarets (recurrent meningitis) headache
recurring headaches with menigeal irritation signs and fever each time
40
[Headache]: If mollarets headache suspected what is the 1st line Ix and what are you looking for
LP and send CSF for HSV2 pcr
41
[Headache]: If there is access to the SAH (e.g. fracture) organisms may be given entry. What headache cause may follow
Mollarets (recurring meningitis)
42
[Headache]: What is the major worry with giant cell arteritis
blindness (GCA affect retinal artery, ischaemia is v damaging)
43
[Headache]: Giant cell arteritis must be excluded if the headache is in someone aged ....
>50 yrs
44
[Headache]: What would be the main findings on palpation of temporal arteries in GCA (3)
pulseless
tender
thickened
45
[Headache]: GCA may have produce what sign in the jaw
jaw claudication
46
[Headache]: what is the pattern of onset in GCA
Sub acute
47
[Headache][cluster]: is more common in M or F?
M
5:1
48
[Headache][cluster]: time-course presentation?
rapid onset
49
[Headache][cluster]: where does the pain present?
around 1 eye
50
[Headache][cluster]: what eye-related features may be present on pain onset (4)
lacrimation
lid swelling
miosis
ptosis (20%)
51
[Headache][cluster]: do recurring attacks always affect the same eye?
YES
52
[Headache][cluster]: during what time do the attacks often occur
night time
53
[Headache][cluster]: how long does the cluster period last
4-12 weeks
54
[Headache][cluster]: how long can the latency period between cluster last
2 years
55
[Headache][cluster]: how long will the acute attack last
15 mins -2 hours
56
[Headache][cluster]: when is O2 CI
COPD
57
[Headache][cluster]: what is 1st line pharmacological Tx
Sumatriptan (sc)
58
[Headache][cluster]: how does sumatriptan work
5HT analog. receptor in cranial arteries, reduces vascular inflammation.
59
[Headache][cluster]: what should be given and 1st line Tx (non-pharmacological)
100% O2, non-rebreathe
(CI in what?)
60
[Headache][cluster]: what is an alternative to sumatriptan
Zolmitriptan nasal spray
61
[Headache][cluster]: Pain is strictly limited to .... side(s)
one side
62
[Headache][cluster]: this is the most debilitating headache T/F
T
63
[Headache][trigeminalneuralgia]: classical symptoms
paroxysmal stabbing pain
64
[Headache][trigeminalneuralgia]: where is the pain felt
Mandibular and maxillary usually
65
[Headache][trigeminalneuralgia]: unilateral or bilateral
unilateral
66
[Headache][trigeminalneuralgia]: length of symptoms
seconds
67
[Headache][trigeminalneuralgia]: explain 'tic doloureux'
face screwing up with pain
68
[Headache][trigeminalneuralgia]: How is the pain frequently brought on (5)
washing
shaving
eating
talking
dental prostheses
69
[Headache][trigeminalneuralgia]: typical age of onset
>50 yrs
70
[Headache][trigeminalneuralgia]: secondary causes (2)
compression of the trigeminal nerve
meningeal inflammation (MS, zoster)
71
[Headache][trigeminalneuralgia]: 1st line Ix
MRI
72
[Headache][trigeminalneuralgia]: why is the 1st line Ix important
exclude secondary causes
73
[Headache][trigeminalneuralgia]: 1st line Tx?
Carbamazepine 100mg
74
[Headache][trigeminalneuralgia]: how does carbamazepine work
Stabilises Na channels. Neurons less excitable
75
[Headache][trigeminalneuralgia]: If 1st line tx does not work in relapse; 2nd line drugs? (3)
Lamotrigine
phenytoin
gabapentin
76
[Headache][trigeminalneuralgia]: how do lamotrigine/phenytoin and carbamazepine all work
Block Na gate channels
77
[Headache][trigeminalneuralgia]: if relapse still occurs, what is non-pharmacological option
surgical intervention of peripheral CN 5
78
[Headache]: Giant cell arteritis must be excluded if the headache is in someone aged >50 and is persisting for ...
>2weeks
