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NBB Test 1 > Headache > Flashcards

Headache Flashcards

1
Q

What are the three major primary headache disorders?

  • Represent 80-90% of headaches
  • entirely diagnosed by history
A

Migraine, tension-type headache, and trigeminal autonomic cephalalgias

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2
Q

Has the feature of being unilateral, but not side-locked with a pounding or throbbing quality

A

Migraine

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3
Q

Three phobia features of migraines are

A

Photophobia, phonophobia, and osmophobia

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4
Q

Migraines can have nausea with or without vomiting and typically last

A

4-24 hours

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5
Q

Begins 5-30 minutes before migraine and typically lasts 15-30 minutes

A

Aura (classic presentation)

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6
Q

Characterized by flashing lights/bars (scotomata) and is sometimes somatosensory

A

Aura

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7
Q

Worsened by activity and patients prefer to sleep off the headaches in a dark, quiet room

A

Migraine

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8
Q

Very common when there is familial history and patients with a history of motion sickness

A

Migraines

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9
Q

What is a comorbidity of migraines?

A

Anxiety and depression

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10
Q

Migraines can occur at any age, but prevalence increases steeply at ages

A

10-14 until 35-39

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11
Q

Migraines are 2-3 times more common in

A

Women

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12
Q

Incidence declines greatly in women following menopause

A

Migraines

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13
Q

Mediates pain from cerebrovasculatureand craniofacial region

A

Trigeminal ganglion

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14
Q

Symptoms of a migraine suggest origin in the

A

Brainstem, hypothalamus, cortex, or limbic system

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15
Q

Cortical spreading depression

A

Neurobiology migraine aura

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16
Q

In a migraine, behind zone of activation is zone of depression (depolarization), which correlates with the onset of

A

Headache

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17
Q

Usually starts while flow is diminished

A

Headache

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18
Q

Isn’t severe enough to cause ischemia

A

Oligemia

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19
Q

What are the 4 abortive treatments of migraines?

A

NSAIDS, anti-emetics, Triptans/ergots, or combination

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20
Q

A major pharmacologic preventative medication for migraines is

A

CGRP inhibitors

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21
Q

Hunger, dehydration, and lack of sleep are known triggers of

A

Migraines

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22
Q

What are two forms of migraines of higher severity?

A

Status migrainosus and transformed migraines

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23
Q

Migraine lasting longer than 72 hours

A

Status migrainosus

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24
Q

Migraines that move into chronic daily headaches

A

Transformed migraines

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25
Q

Typically a bilateral pressing or tightening in quality and of mild to moderate intensity

-Most common headache type

A

Tension headaches

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26
Q

Lasts minutes to days and lacks migrainous features

A

Tension headache

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27
Q

You can see increased pericranial tenderness by manual palpation with a

A

Tension Headache

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28
Q

Affects 0.5-5% of the population and is slightly more prevalent in women than men

A

Tensions headaches

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29
Q

Tension headaches are more common in those with

A

Depression and generalized anxiety disorder

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30
Q

1/4 of patients with fibromyalgia had a prior diagnosis of chronic

A

Tension Headaches

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31
Q

Characterized as cluster headaches

A

Trigeminal Autonomic Cephalalgias

32
Q

What are the two forms of trigeminal autonomic cephalalgias

A

SUNCT and SUNA

33
Q

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing

A

SUNCT

34
Q

Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms

A

SUNA

35
Q

Has autonomic features ipsilateral to the headache

A

Trigeminal autonomic cephalalgias

36
Q

1-8 attacks per day and attacks occur in series lasting for weeks or months

A

Cluster headaches

37
Q

Separated by remission periods usually lasting months or years

-Maximal orbitally, supraorbitally, and temporally

A

Cluster headaches

38
Q

With cluster headaches, patients have a sense of

A

Restlessness or agitation

39
Q

Cluster headaches are more common in

A

Men (302) than women (20s or 60s)

40
Q

Cluster headaches are different than a migraine because they have no

A

Prodrome or aura

41
Q

Cluster headaches last

A

15 minutes to hours

42
Q

Often awaken patients in the middle of the night and are periodic, occurring at the same time of day/same time of year

A

Cluster headaches

43
Q

55% of patients with cluster headaches have contemplated

A

Suicide

44
Q

With cluster headaches, we see activation in the

A

Ipsilateral posterior hypothalamic gray matter

45
Q

Inherited cases of cluster headaches makes up about 5% of cases. The inheritance pattern is

A

Autosomal dominant

46
Q

The autosomal dominant cluster headaches are due to mutations in the

A

Hypocretin receptor 2 gene (HCRTR2)

47
Q

The headache often begins in sleep and is linked to sleep apnea with

A

Cluster headaches

48
Q

Severe, strictly unilateral pain which is orbital, supraorbital, temporal, lasting 2–30 minutes and occurring several or many times a day

A

Paroxysmal Hemicrania

49
Q

Non-stop > 3 months; incessant, sometimes severe, sidelocked headache that will only respond to indomethacin

A

Continua Hemicrania

50
Q

Moderate or severe unilateral head pain, with orbital, supraorbital, temporal and/or other trigeminal distribution, lasting for 1–600 seconds and occurring as single stabs, series of stabs or in a sawtooth pattern

A

SUNCT

51
Q

Attacks last 7 days to 1 year, separated by pain-free periods lasting at least 1 month

A

SUNA

52
Q

Should be used initially to treat hemicrania

A

Indomethacin

53
Q

What is the daily dose of indomethacin used for hemicrania?

A

150 mg daily but can be increased to up to 225

54
Q

Indicated for the following headaches: paroxysmal hemicrania, cough-induced, ice pick (stabbing), SUNCT

A

Indomethacin

55
Q

What are the three main types of trigeminal autonomic caphalgias?

A

Cluster, Paroxysmal hemicrania, and SUNCT

56
Q

Commonly called the “ice pick headache”

-Jabs and jolts

A

Primary stabbing headache

57
Q

Headache attributed to external application of cold stimulus or ingestion/inhalation of a cold stimulus

A

Cold-Stimulus headache

58
Q

It is important to focus on cranial nerve examination and fundoscopy (optic discs) for

A

Secondary headaches

59
Q

Dull, deep, throbbing in center of head –forehead, nasal bridge, upper cheeks

-often starts after a bad cold

A

Sinus headache

60
Q

Worse with bending down or leaning over and worse in cold and damp weather

A

Sinus headache

61
Q

Pressure-like pain behind one specific part of face, postnasal drip and red and swollen nasal passages

A

Sinus headache

62
Q

Taking abortive medications more than twice weekly in general can cause headaches occurring more than 15 days per month. This is called a

A

Medication overuse headache

63
Q

Regular overuse for >3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache

A

Medication overuse headache

64
Q

What are some of the common causes of medication overuse headaches?

A

Opiods, caffeine, and Triptans

65
Q

Elevated/high intracranial pressure with no structural CNS abnormality and no CSF outflow obstruction

A

Idiopathic intracranial hypertension (Pseudotumor Cerebri)

66
Q

What are three common signs we would see in a patient with Idiopathic intracranial hypertension (Pseudotumor Cerebri)

A

Overweight, blurred vision with papilledema, and high opening pressure in lumbar puncture

67
Q

Cranial nerve VI palsy is also a common symptom of

A

Idiopathic intracranial hypertension (Pseudotumor Cerebri)

68
Q

“Spinal headache”, “Spinal leak” after lumbar puncture (LP)

-Only occurs upon sitting or standing

A

Low CSF pressure headache

69
Q

A ruptured Tarlov cyst can cause a

A

Low CSF pressure headache

70
Q

Downward displacement of cerebellar tonsils at least 3 mm into upper cervical canal

-Common syringomyelia (syrinx) (hydromyelia) cervical > cervicothoracic

A

Chiari I mlformation

71
Q

What are two treatments for a Chiari I malformation?

A

Suboccipital craniectomy, C1 ring laminectomy

72
Q

Has the clinical features of occipital or upper cervical headache with Valsalva [bending over, laughing, coughing and sneezing]

A

Chiari I malformation

73
Q

Also characterized by down-beating nystagmus

A

Chiari I Malformation

74
Q

Neuropathic pain in the distribution of a cranial nerve

-Sharp, brief, and lancinating

A

Cranial Neuralgias

75
Q

Inflammatory arteritis of the temporal artery causing headache, monocular visual loss and jaw claudication

A

Temporal Arteritis

76
Q

Temporal arteritis is characterized by

A

Increased Erythrocyte Sedimentation Rate (Greater than 100 mm/hr)

NBB Test 1 (20 decks)

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