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NU734 Acute Care I > Headache > Flashcards

Headache Flashcards

1
Q

primary HA

A
  • Migraine
  • Tension
  • Trigeminal Autonomic Cephalilgia
  • Cluster
  • Paroxysmal Hemicrania
  • Short-lasting unilateral neuralgiform (SUNA )
  • Hemicrania Continua
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2
Q

Secondary

A
  • Turmoer
  • Bleed
  • Increase ICP
  • Injury
  • Other medications
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3
Q

Primary

Migraine

A
  • **Unilateral **
  • Trobbing/Pulsatile
  • Photophobia
  • N/V
  • 2 to 72 hrs
  • PIN acronym ( Pulsation ; Intensity Nausea )
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4
Q

Primary
Tension Type of HA

A

Bilateral
Mild to moderate
Non throbing
30 mitns to 7 days

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5
Q

Cluster

A
  • Uniateral
  • Orbinal /Tempral
  • Severe Attack
  • last 15 mints to 180 mintutes
  • Ipsilateral autonimic symtoms ( refer to symptoms that occur on the same side of the body as a particular neurological condition or lesion.
  • Periorbital edema , orbital edema
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6
Q

Secondary HA Assessment

A
  • Rule out serious underlying pathology and differentials
  • Throught H and P: OLDCARS
  • Red Flags : **SNNOOP 10 **
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7
Q

SNNOOP 10

A
  • Systmeic Symptoms
  • Neoplasm
  • Neurologix deficit
  • Onset sudden or abrupt
  • Onset >50 yrs
  • Pattern change of new HA
  • POstion of hA
  • Precipita sneey
  • Pregnancy
  • Painful eyy
  • Post trauma
  • HIV
  • Pain med over use
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8
Q

Thunderclap Headache

A

***** Severe and Sudden Onset
* Last seconds to only a mint
* May have N/V/F or Seizures

**Plan: **
Urgen Evaluation to R/O :
SAH
HTN Crisis

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9
Q

Secondary HA

Dx

A

**Emergency settings : **
* CT w/ contrast
* CT W/O contrast
* Lumbar Puncture
**Non-emergenent settings
*** MRI of brain w constrast

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10
Q

Secondary HA :
**Lumbar Puncture **

A

**Indication of LP : **
* Clinical supicion of SAH **w/negative head CT **
* Evaluation CSG for RBCs
* Infectioous
* Inflamation
* Neoplastic

Urgent LP
* ****Suspect infectio or SAH
* **Non-Emergent”
**Carcinom, NS, GBS, vasulitis
***

***CSG: C ( canser) S ( SAH ) F (fever/infection ) **

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11
Q

LP contraindication

A
  • Infection to skin
  • brain abcess
  • midline shift
  • increase ICP
  • Anticoagulation
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12
Q

LP complication

A

Herniation : most serious
Post LP HA

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13
Q

Migrain TX

A

Triptans + NSAIDS
Antiematics

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14
Q

TX Tension HA

A

NSAID
Caffeine+ Tylenol +ASA
Firocet not recommended as 1st line tx

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15
Q

Cluster Tx

A

Oxygen ( NRM 10L upper position )
Triptans
Verapamil ( Chronic ha )

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16
Q

Secondary HA TX

A

Dx the problem and treat underlying contidion

17
Q

Hepiphlegic Migraine
Clinical Findings

A

**Hallmark sign **
* Unilateral weakness after a migrain e
* Imparied vision, speech, sensation

**Motor Auras
* ** Two or more experineced visual, sensory, aphasia)
* Envolves over 20 mints with hours to resoved

Heat CT or MRI

18
Q

Hemiplegic Migraine
DX

A
  • Reversible aura
  • Aura spreads gradually, gradually, two or more occure in succession
  • At least one aura is unileteral
  • Accompanied by HA
  • At least two attacks as above
19
Q

Mecications to Avoid

A

Triptans
Beta Blockers

20
Q

Bell’s Palsy

A
  • Facial Nerve Palsy : CN VIII
  • **Most Common Cause: **
  • Viral
  • Herpes Simplex
21
Q

CN VIII

A

Facial

22
Q

Bell’s Palsy S/S

A

General neuro exam
Facial movement
External ear with any scabbin or vesicle(herpers)
Parotid mass
Sparing of the forehead ( central etiology): condition or symptom affects most of the face except the forehead.

23
Q

Bells Palsy Imaging and Dx

A

EMG
CT scan
Blood studies: R/O sytemic diseases

24
Q

Bells Palsy TX

A

Glucotricoid
* Prednisone 60 mg to 80 mg /day for 1 wk
* Artificial tears
* Patch HS

25
Q

CN V

A

Trigeminal

26
Q

Trigeminal assessment

A
  • Recurrent and brief unilateral facial pain
  • Abrupt onset/termination
  • fast occuring
  • severe intesity
  • **Shock like **
  • **Trigeminal nerve root compression **
27
Q

Trigeminal : DX or tX

A

CT or MRI : ID structure lesion s
Hear MRA : Vascular

TX: Carbamazepine 10 0 to 200 BID

NU734 Acute Care I (23 decks)

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