Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pnt Exam 2 > headache > Flashcards

headache Flashcards

1
Q

examples of primary headache

A

migraine, tension type, or cluster and other trigeminal autonomic cephalgias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define secondary headache and give example

A

caused by an underlying medical disorder. medication overuse headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

examples of headache triggers

A

hormonal, environmental, emotional (stress, menstruation, weather, caffiene)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

define chronic headache

A

occurs 15+ days/month for 3+ months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

define status migrainosus

A

severe and debilitating migraines for 72+ hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

who is brain imaging recommended for diagnosis of migraine headache

A

pts with risk factors of intracranial pathology (acute onset, 55+, abnormal neuological exam)
localized neurological signs (numbness, tingling)
Frequent, prolonged, severe attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

To classify tension headaches as episodic how often do they occur

A

3 days per month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

to classify tension headaches as chronic how often do the occur

A

15+ times per month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common type of primary headache

A

tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

tension headaches are more common in which gender

A

female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the least common type of primary headache

A

cluster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cluster headaches are more common in which gender

A

male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

cluster headaches pathophysiology

A

unsure. possibly hypothalamic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of cluster headaches

A

genetics

tobacco/alcohol use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how often are episodic cluster headaches

A

lasting weeks to months with remission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how often are chronic cluster headaches

A

1 year without remission or remission less than 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

frequency of cluster headaches

A

once every other day to 8 per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Headache Alarm symptoms

A

acute onset of first or worst headache ever
accelerating pattern of headaches after initial subacute presentation
onset of headache after 50
headache assocaited with systemic illness (fever, N/V, neck stiffness, rash)
headache with focal neurological symptoms or papilledema
new onset headache in patient with cancer or HIV (immunocompromised)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how many attacks to diagnose migraine without aura

A

5+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how many attacks to diagnose migraine with aura

A

2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how many attacks to diagnose tension type headache

A

10+ attacks on average < 1 per month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how many attacks to diagnose cluster headache

A

5+ attacks on average 1+/day more than half of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

migraine without aura must have 2+ of these characteristics

A

pain increase or decrease with physical activity
unilateral
pulsating
moderate to severe intensity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

migraine with aura must have 1+ of these characteristics with no motor weakness

A 
visual symptoms (+/-) 
sensory symptoms (+/-) 
dysphasic speech, moerate or severe intensity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

tension type headache must have 2+ of these characteristics

A

bilateral
nonpulsating
mild or moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

cluster headache characteristics

A

unilateral
orbital, supraorbital, or temporal
sharp, stabbing, severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

migraine without aura must have 2+ of the following other symptoms

A 
nausea
vomiting
photophobia
phonophobia
osmophobia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

duration of migraine without aura

A

4 to 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

migraine with aura must have 2+ of the following other symptoms

A

homonymous visual symptoms and/or unilateral sensory symptoms
1 aura develops 5+ minutes prior and/or a second aura develope in 5 minutes after HA start
duration 5-60 mintes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

duration of migraine with aura

A

5-60 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

tension type headache must have 2+ of the following other symptoms

A

no nausea or vomitting AND either photophobia or phonophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

duration of tension type headache

A

30 minutes to 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

cluster headaches must have 1+ of the following other symptoms

A

conjuntival injection and/or lacrimation
nasal congestion and/or rhinorrhea
eyelid edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

duration of cluster headache

A

15-180 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

goals of therapy for headache

A

reduce attack frequency, severity, and disability
reduce reliance on ineffective, poorly tolerated acute treatment medications (avoid overuse and dependence of analgesics)
improve QOL
avoid acute headache medication escalation
reduce headache related distress and psychological symptoms
reduce frequency and severity within a cluster series
delay or eliminate recurrent periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

non pharm treatment of headache

A 
headache diary
avoid exposure to triggers
behavioral interventions
reduce alcohol and tobacco use
accupuncture
psychological intervention
relaxation techniques
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

medications that can trigger headache

A

nitrates, estrogen/oral contraceptives, nifedipine, ondansetron, indomethacin, cimetidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what medications can cause headaches as withdrawl from overuse

A

analgesics, Benzos, decongestants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

behavioral headache triggers

A 
fatigue
menstruation or menopause
sleep excess or deficit
stress
vigorous physical activiy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

environmental headache triggers

A 
flickering lights
high altitude
loud noises
strong smells
tobacco smoke
weather changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

food headache triggers

A 
alcohol
caffeine intake or withdrawl
chocolate
citrus fruits, bananas, figs, raisins
dairy products
fermented or pickled products
MSG containing (asain, seasoned salt) 
Saccharin/aspartame (diet soda/food) 
Sulfites (shrimp) 
Tyramine (cheese, wine, organ meats) 
Yeast (breads)
42
Q

Pharm treatment for mild-moderate migraine

A

APAP+ASA+ caffeine; NSAIDS

43
Q

Pharm treatment for moderate-severe or when simple analgesics not effective

A

Triptans

44
Q

Triptans used to treat migraines

A 
almotriptan
eletriptan
frovatriptan
naratriptan
rizatriptan
sumatriptan
zolmitriptan
45
Q

AEs of triptans

A

dizziness, warm sensation, chest fullness, nausea

RARE: ischemic event due to vasoconstriction

46
Q

MOA of triptans

A

selective 5HT 1B/1D/1F agonists
vasoconstriction
inhibit inflammation
central inhibition of pain

47
Q

Contraindications to all triptans

A

cardiovascular: ischemic heart disease, angina, mocardial infarction, myocardial ischemia, PVD
cerebrovascular: TIA, stroke
Uncontrolled HTN
within 24 hours of ergot derivatives

48
Q

additional contraindication to eletriptan

A

use of CYP 3A4 inhibitors within 72 hours (azole antifungals, clarithromycin)

49
Q

additional contraindication to naratriptan

A

CrCl < 15 and/or severe hepatic impairment

50
Q

Almotriptan brand name

A

axert

51
Q

eletriptan brand name

A

relpax

52
Q

frovatriptan brand name

A

frova

53
Q

naratriptan brand name

A

amerge

54
Q

rizatriptan brand name

A

maxalt / maxalt MLT

55
Q

sumatriptan brand name

A

imitrex

56
Q

sumatriptan/naproxen brand name

A

treximet

57
Q

zolmitriptan brand name

A

Zomig / Zomig ZMT

58
Q

Almotriptan routes

A

oral

59
Q

eletriptan routes

A

oral

60
Q

frovatriptan routes

A

oral

61
Q

naratriptan routes

A

oral

62
Q

rizatriptan routes

A

oral

ODT

63
Q

sumatriptan routes

A

subQ

oral

64
Q

Sumatriptan/naproxen route

A

nasal spray

oral

65
Q

Zolmitriptan routes

A

oral
ODT
nasal spray

66
Q

almotriptan drug interactions

A

ergot derivative

67
Q

eletriptan drug interactions

A

CYP 3A4
CYP 2D6
ergot derivatives

68
Q

frovatriptan drug interactions

A

CYP 1A2

ergot derivatives

69
Q

naratriptan drug interactions

A

CYPs, ergot derivatives

70
Q

Rizatriptan drug interactions

A

Ergot derivatives

MAO-A Inhibitors

71
Q

Sumatriptan drug interactions

A

ergot derivatives

MAO-A inhibitors

72
Q

Zolmig drug interactions

A

CYP 1A2
ergot derivatives
MAO-A inhibitors

73
Q

ergotamine alkaloids used in migraine

A

dihydroergotamine (DHE)

ergotamine

74
Q

MOA of ergotamine alkaloids

A

typtaminergic, dopaminergic, alpha adrenergic receptors

vasoconstriction

75
Q

AEs of ergotamines

A

nausea (give antiemetic)

76
Q

Pregnancy category of ergotamines

A

X

77
Q

Contraindications with ergotamines

A

Cardiovascular: ischemic heart disease, angina, MI, myocardial ischemia, PVD
Uncontrolled HTN
Use within 24 hours of triptans and other serotonin agonists, ergot-like agents
Severe hepatic/renal impairment
Sepsis
Pregnancy/nursing

78
Q

How are opioids used for migraine

A

rescue therapy

79
Q

when is butorphanol nasal spray used for migraine

A

when others are contraindicated

80
Q

AEs of opioids

A 
sedation
drowsiness
dizziness
n/v
constipatoin
(nasal congestion/insomnia with nasal spray)
81
Q

Which medications are not used in tension type headache

A

butalbital combos
opioids
benzos

82
Q

tension headaches are typically treated how

A

nonpharm (ice pack/massage) and OTC (NSAIDS, APAP)

83
Q

what is given for tension headache if nonpharm/OTC not effective

A

antidepressant with sedative effects (amitriptyline)

84
Q

What routes are preferred for cluster headache

A

non-oral

85
Q

What medications are recommended for cluster headache

A

sumatriptan subQ and zolmitriptan nasal spray

86
Q

4 medications that can be used for cluster

A

triptans
oxygen
lidocaine/cocaine hydrochloride
octreotide

87
Q

Medication overuse headache occurs how often

A

15+ days per month

88
Q

what medications contribute to medication overuse headache

A 
ergotamine
triptans
opioids
combo analgesics
simple analgesics
89
Q

how long is a medication taken regularly before medication overuse headache

A

3+ months

90
Q

How long after d/c medication will medication overuse headache resolve

A

within 2 months

91
Q

how to manage medication overuse headache

A

aburpt stop better than taper

TCA

92
Q

Who should get headache prevention

A

frequent, severe, or lead to significant disability
Migraines with neurologic focality
APAP/NSAIDs 2+ days/week

93
Q

medications used to prevent migraines

A 
beta blockers
ACE/ARB
Antidepressants
Antiepileptics
Triptans
Alpha agonists
94
Q

Which beta blockers are used for migraine prevention

A 
propranolol
metoprolol
timolol
atenolol
nadolol
95
Q

Which ACE/ARBs are used for migraine prevention

A

lisinopril

candesartan

96
Q

Which antidepressants are used for migraine prevention

A

amitriptyline

venlafaxine

97
Q

Which antiepileptics are used for migraine prevention

A

divalproex sodium
sodium valproate
topiramate
carbamazepine

98
Q

Which triptans are used for migraine prevention

A

frovatriptan
zomitriptan
naratriptan

99
Q

which alpha agonists are used for migraine prevention

A

clonidine

guanfacine

100
Q

What medications are used to prevent tension headache

A 
similar to migraine
TCA
muscle relaxants
botulinum toxin (severe cases) 
intranasal capsacin
suboccipital steroid injection
verapamil
lithium
melatonin
101
Q

What medications can be used to manage headache in pregnancy

A

APAP
antiemetics
opioids
corticosteroids

102
Q

What headache medications are contraindicated in pregnancy

A 
NSAIDs
Triptans
Ergotamines
beta blockers
calcium channel blockers
antiepileptics

Pnt Exam 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions