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6. Neurology (Medical Knowledge) > [headache] > Flashcards

[headache] Flashcards

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USMLE® Step 1 flashcards
1
Q
A

meningeal irritation

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2
Q
A

Meningitis
Encephalitis
SAH

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3
Q
A

Encephalitis

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4
Q
A

Odd behaviour
reduced consciousness
fits

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5
Q
A

Meningitis

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6
Q
A

Occipital (often, not always)

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7
Q
A

Urgent CT
(SAH presents with meningeal irritation)

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8
Q
A

LP
(infection or blood products in CSF)

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9
Q
A

Subdural haematoma
Extradural haematoma

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10
Q
A

CT

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11
Q
A

Subdural haematoma
extra-dural haematoma

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12
Q
A

Venous sinus thrombosis

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13
Q
A

dull constant ache

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14
Q
A

frontal sinuses
maxillary sinuses

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15
Q
A

Rhinoviruses

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16
Q
A

Common cold

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17
Q
A

Low pressure CSF (leakage)

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18
Q
A

acute glaucoma

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19
Q
A

Acute glaucoma

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20
Q
A

IV Acetazolamide
(pilocarpine)

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21
Q
A

M3 muscle-r agonist. Causes cilliary contraction. Increases outflow of aqueous humour.

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22
Q
A

Carbonic anhydrase-i
Decreases secretion of aqueous humour

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23
Q
A

sudden onset

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24
Q
A

worst ever headache

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25
Q
A

Dilated and unresponsive

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26
Q
A

acute glaucoma

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27
Q
A

Medication overuse
(aka analgesic rebound headache)
Tension headache
Raised ICP

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28
Q
A

Coughing
Bending over
on waking

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29
Q
A

T

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30
Q
A

imaging to look for space occupying lesion (CT)

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31
Q
A

AFTER imaging

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32
Q
A

Odd behaviour
Papilloedema
seizures
vomiting

33
Q
A

Bilateral non-pulsatile headache
(not affected by head movement)

34
Q
A

analgesic overuse (esp. mixed analgesics)

35
Q
A

6days/month

36
Q
A

stress relief

37
Q
A

no

38
Q
A

Migraine
Cluster headache
Trigeminal neuralgia
Recurrent meningitis (Mollarets)

39
Q
A

recurring headaches with menigeal irritation signs and fever each time

40
Q
A

LP and send CSF for HSV2 pcr

41
Q
A

Mollarets (recurring meningitis)

42
Q
A

blindness (GCA affect retinal artery, ischaemia is v damaging)

43
Q
A

> 50 yrs

44
Q
A

pulseless
tender
thickened

45
Q
A

jaw claudication

46
Q
A

Sub acute

47
Q

[Headache][cluster]: is more common in M or F?

A

M
5:1

48
Q

[Headache][cluster]: time-course presentation?

A

rapid onset

49
Q

[Headache][cluster]: where does the pain present?

A

around 1 eye

50
Q

[Headache][cluster]: what eye-related features may be present on pain onset (4)

A

lacrimation
lid swelling
miosis
ptosis (20%)

51
Q

[Headache][cluster]: do recurring attacks always affect the same eye?

A

YES

52
Q

[Headache][cluster]: during what time do the attacks often occur

A

night time

53
Q

[Headache][cluster]: how long does the cluster period last

A

4-12 weeks

54
Q

[Headache][cluster]: how long can the latency period between cluster last

A

2 years

55
Q

[Headache][cluster]: how long will the acute attack last

A

15 mins -2 hours

56
Q

[Headache][cluster]: when is O2 CI

A

COPD

57
Q

[Headache][cluster]: what is 1st line pharmacological Tx

A

Sumatriptan (sc)

58
Q

[Headache][cluster]: how does sumatriptan work

A

5HT analog. receptor in cranial arteries, reduces vascular inflammation.

59
Q

[Headache][cluster]: what should be given and 1st line Tx (non-pharmacological)

A

100% O2, non-rebreathe

(CI in what?)

60
Q

[Headache][cluster]: what is an alternative to sumatriptan

A

Zolmitriptan nasal spray

61
Q

[Headache][cluster]: Pain is strictly limited to …. side(s)

A

one side

62
Q

[Headache][cluster]: this is the most debilitating headache T/F

A

T

63
Q

[Headache][trigeminalneuralgia]: classical symptoms

A

paroxysmal stabbing pain

64
Q

[Headache][trigeminalneuralgia]: where is the pain felt

A

Mandibular and maxillary usually

65
Q

[Headache][trigeminalneuralgia]: unilateral or bilateral

A

unilateral

66
Q

[Headache][trigeminalneuralgia]: length of symptoms

A

seconds

67
Q

[Headache][trigeminalneuralgia]: explain ‘tic doloureux’

A

face screwing up with pain

68
Q

[Headache][trigeminalneuralgia]: How is the pain frequently brought on (5)

A

washing
shaving
eating
talking
dental prostheses

69
Q

[Headache][trigeminalneuralgia]: typical age of onset

A

> 50 yrs

70
Q

[Headache][trigeminalneuralgia]: secondary causes (2)

A

compression of the trigeminal nerve
meningeal inflammation (MS, zoster)

71
Q

[Headache][trigeminalneuralgia]: 1st line Ix

A

MRI

72
Q

[Headache][trigeminalneuralgia]: why is the 1st line Ix important

A

exclude secondary causes

73
Q

[Headache][trigeminalneuralgia]: 1st line Tx?

A

Carbamazepine 100mg

74
Q

[Headache][trigeminalneuralgia]: how does carbamazepine work

A

Stabilises Na channels. Neurons less excitable

75
Q

[Headache][trigeminalneuralgia]: If 1st line tx does not work in relapse; 2nd line drugs? (3)

A

Lamotrigine
phenytoin
gabapentin

76
Q

[Headache][trigeminalneuralgia]: how do lamotrigine/phenytoin and carbamazepine all work

A

Block Na gate channels

77
Q

[Headache][trigeminalneuralgia]: if relapse still occurs, what is non-pharmacological option

A

surgical intervention of peripheral CN 5

78
Q
A

> 2weeks

6. Neurology (Medical Knowledge) (24 decks)

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