[headache][migraine]

Question 1

[headache][migraine]: how long do visual aura last

Answer 1

15-30 mins

Question 2

[headache][migraine]: what precedes the headache by c.1hr

Answer 2

visual aura

Question 3

[headache][migraine]: how is the headache described

Answer 3

throbbing

Question 4

[headache][migraine]: what is the distribution of the headache

Answer 4

unilateral

Question 5

[headache][migraine]: can the aura and headache present independently

Answer 5

yes

Question 6

[headache][migraine]: allodynia may be present. What is it

Answer 6

all stimuli produce pain

Question 7

[headache][migraine]: what may precede the headache by days (prodrome) (2)

Answer 7

cravings
sleep disturbances

Question 8

[headache][migraine]: how might the pt describe the aura

Answer 8

melting of lines
hemianopia

Question 9

[headache][migraine]: what ocular involvement may there be apart from visual hallucinations

Answer 9

ophthalmoplegia

Question 10

[headache][migraine]: paraesthesia may typically spread from … to …

Answer 10

fingers to face

Question 11

[headache][migraine]: if there is no aura what is the minimum number of headaches lasting 4-72hrs required for Dx

Answer 11

5

Question 12

[headache][migraine]: if there is no aura what associations must be present (2)

Answer 12

nausea/vomiting
photo/phonophobia

Question 13

[headache][migraine]: if there is no aura what 3 characteristics must the pt describe about the headache

Answer 13

Worsened by usual activity
unilateral
pulsating

Question 14

[headache][migraine]: what is the mneumonic for remembering potential triggers

Answer 14

Chocolate

Question 15

[headache][migraine]: what does chocolate stand for

Answer 15

Chocolate
hangovers
orgasms
cheese
oral contraceptives
lie-ins
alcohol
tumult
exercise

Question 16

[headache][migraine]: what may be a ∆∆ for the aura

Answer 16

TIA

Question 17

[headache][migraine]: 1st line Mx (2)

Answer 17

ketoprofen
aspirin (dispersible)

Question 18

[headache][migraine]: When are triptans CI (4)

Answer 18

IHD
cardiac spasms
uncontrolled BP
SSRIs/lithium
ergot use

Question 19

[headache][migraine]: 2nd line drug Tx

Answer 19

Rizatriptan

Question 20

[headache][migraine]: SE of triptans

Answer 20

MI/arrhythmias

Question 21

[headache][migraine]: 3rd line Tx of migraine

Answer 21

Ergotamine
as the headache starts

Question 22

[headache][migraine]: how does ergotamine work

Answer 22

5HT analog
Contricts cerebral blood vessels

Question 23

[headache][migraine]: non pharmacological Tx?

Answer 23

rebreathing into a paper bag

Question 24

[headache][migraine]: prevention of migraine 1st line drug (3)

Answer 24

Propranolol
Amitriptiline
topiramate

Question 25

[headache][migraine]: what is happening to the cerebral arteries during the aura and headache

Answer 25

Constricting (aura)
dilating (headache)

Question 26

[headache][migraine]: females on the Pill who have migraines are at increased risk of

Answer 26

Stroke
(low dose pill onky)

Question 27

[headache][migraine]: migraine in pregnancy. What drug for prophylaxis

Answer 27

Amitriptiline

Question 28

[headache][migraine]: what is amitriptiline

Answer 28

TCA (tricyclic antidepressant)

Question 29

[headache][migraine]: what is a ‘common migraine’

Answer 29

headache without aura

Question 30

[headache][migraine]: ataxia suggests a … migraine

Answer 30

basilar

Question 31

[headache][migraine]: what are the dangers with ergots that you must emphasise (2)

Answer 31

Vascular disease
gangrene

Question 32

[headache][migraine]: in chronic severe migraine what is the last resort Tx

Answer 32

Botulinum tox A injection (12 weekly)