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NEUROLOGY > Headaches > Flashcards

Headaches Flashcards

1
Q

Unilateral pulsatile(throbbing pain) preceded by flashing light or zigzag line (aura), photophobia

A

Migraine

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2
Q

Pain over one eye, lasting for a minutes to hours associated with lacrimation, rhinorrhea and flushing of the forehaed lasts several weeks a few times a year

A

cluster headache

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3
Q

Episodic or chronic, bilateral over the occiput , frontal or temporal, band like or tightness in nature

A

Tension headache

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4
Q

Case: headache in child , band like, throbbing pain, with stress at school

A

tension headache

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5
Q

case: 35 years old female presented with unilateral peri-orbital headache associated with lacrimation and rhinorrhea she claimed that this headache occurs every year at the same toke. WHATS THE ACUTE MANAGEMENT

A

1- 100% oxygen
2-Sumatriptan

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6
Q

Case: 35 years old female presented with unilater peri-orbital headache, associated eith lacrimation and rhinorrhea she claimed that this headache occurs every year at the same time , WHAT DO WE USE AS A PROPHYLACTIC MEDICATION

A

Verapamil (calcium channel blocker)

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7
Q

Generalized headache associated with photophopia with a stiff neck

A

Meningitis

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8
Q

sudden severe onset , initially localized but becomes generalized associated with neck stiffness

A

intra-cerebral bleeding (subdural hemtoma, SAH

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9
Q

Persistent unilateral over the temporal area, associated with blurred vision, diplopia, jaw claudication or pain during eating which can leas to loss of weight

A

Temporal arteritis

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10
Q

cas: 45 years old male diabetic patient presented with dull aching headache increase with straining and coughing, upon examination there is tenderness all over the eyebrows, MOST LIKELY DIAGNOSIS

A

Sinusitis

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11
Q

headache associated with pain or fullness behind the eyes or over the cheeks or forehead يزيد لمن يسجد

A

Acute sinusitis

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12
Q

Pain over the occiput associated with neck stiffness

A

Cervical spondy-losis

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13
Q

case: Patient with unilateral headache on temple area , laboratory results showed ESR 112 MOST LIKEY DIAGNOSIS

A

Temporal arteritis (Giant cell)
age >50 ESR >100

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14
Q

Generalized, worse in the morning and with coughing associated with drowsiness and vomiting, Using OCPs in obese women

A

idiopathic intracranial HTN
raised intracranial pressure (brain tumor or idiopathic intracranial HTN)
pseudotumor cerebri
Papilledema

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15
Q

history of using of analgesia especially codeine and opiate for 10-15 days per month

A

Medication overuse headache

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16
Q

case: Patient developed sudden onset headache when he was bending to take his keys from the ground , described as worst headache in his life WHAT IS THE MOST LIKELY DIAGNOSIS

A

subarachnoid hemorrhage

17
Q

Case: patient with headache same as tension headache band like with stress pain lasted for one month and he is using paracetamol day after day WHAT IS THE TYPE OF HEADACHE

A

OVERUSE DRUG HEADACHE

18
Q

brief paroxysms of unilateral lancinating pain in the V2 or V3 distribution of the trigeminal nerve triggered by light touch of affected area

A

Trigeminal neuralgia treated bu CARBA-MAZEPINE

19
Q

POUND mnemonic to diagnose migraine

A

P ulsatile quality
O ne day duration (4-74 hours)
U nilateral in location
N ausea vomiting
D isabling intensity patient goes to bed

20
Q

Management of migraine
Acute mild to moderate=
acute moderate to severe or poor response to NSAIDs=
Migraine associated with vomiting=

A

Acute mild to moderate= ASPIRIN OR NSAID
acute moderate to severe or poor response to NSAIDs= TRIPTAN
Migraine associated with vomiting=NASAL OR SC triptan

21
Q

Triptan Contra-indications

A

CAD, cerebrovascular disease, brainstem aura and hemiplegic migraine

22
Q

Best treatment for trigeminal neuralgia

A

CARBAMAZEPINE

23
Q

case: A young female presented with unilateral throbbing headache he headache is associated with nausea vomiting she tells you that she is sensitive to light ACUTE TREATMENT?
aspirin, triptan, betablocker, 100% o2?

A

Triptan

24
Q

When to give migraine prophylaxis

A

-Do not respond to therapy
- 10 days per month
-using acute migraine medication >8 days per month
-disabling headache >4 days per month

25
Q

migraine prophylaxis

A

BETA BLOCKER metoprolol, PROPRANOLOL, TIMOLOL,

amitriptyline
topiramate
valporic acid
venlafaxine

26
Q

Case: 25 year old pregnant lady known case of migraine during pregnancy it improved, tried to reduce work stress WHAT IS THE BEST ACCOMPLISHMENT OF PREVENTING MIGRAINE ATTACK?

A

BETA BLOCKER

27
Q

MIGRAINE
ACUTE MANAGEMENT:

PROPHYLAXIS:

A

ACUTE MANAGEMENT:
Mild-moderate= NSAIDs
Moderate-severe= TRIPTAN

PROPHYLAXIS:
BETA BLOCKER

28
Q

Cluster headache
ACUTE MANAGEMENT:

PROPHYLAXIS:

A

ACUTE MANAGEMENT:
100% oxygen

PROPHYLAXIS:
calcium channel blocker VERAPAMIL

29
Q

Tension headache
ACUTE MANAGEMENT:

PROPHYLAXIS:

A

ACUTE MANAGEMENT:
NSAIDs
PROPHYLAXIS:
TCA amitriptyline

30
Q

tx of Subarachnoid hemorrhage

A

urgent neurosurgery referral

31
Q

tx of trigeminal neuralgia

A

CARBAMAZEPINE

32
Q

TX of TEMPORAL ARTERITIS

A

HIGH DOSE STEROID
dont wait biopsy (scared of blindness)

33
Q

Patient presented with worst headache in his
live, negative CT brain, what is the next
investigations?

A

Lumbar puncture

34
Q

Female came complaining of headache and
sudden painful loss of vision, Examination: loss
of vision in right eye. CT brain: pituitary
hemorrhage, MRI brain: pituitary massive
hemorrhage and compressing on optic chiasma
and cavernous sinus. Best next step?

A

Urgent neurosurgery referral

35
Q

Frontal sinus headache, how to reach the
diagnosis?

A

1ˢᵗ in any type of headache
Full history and examination

36
Q

Patient with headache that comes and goes a
lot during the last months and it is usually on
the left or right sinus, she used over the
counter analgesic and decongestants but didn’t
help, she complains now of severe headache,
she’s otherwise healthy with no symptoms,
what will you order to confirm the diagnosis?

A

CT of paranasal sinuses

sinusitis

37
Q

Describe migraine headache?

A

Unilateral throbbing headache

38
Q

patient presented with worst headache in his
live, negative CT brain, what is the next
investigations?

A

Lumbar puncture looking for xanthochromia

NEUROLOGY (11 decks)

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