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Medical Pathology > Headaches > Flashcards

Headaches Flashcards

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USMLE® Step 1 flashcards
1
Q

what is the most common complaint of man; more than 1/2 americans report one each year; 1 out of 3 people has had one; can be felt around the eyes ; 1% are high risk

A

HA

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2
Q

what are most Ha caused by

A

muscle Cxn or blood flow probs

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3
Q

what are the main types of HA

A

Tenstion Type ( 78%), migraine ( 16%) , cluster (0.4 %) , and other > primary HA

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4
Q

in this type of HA, pain is in and around the eye

A

cluster

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5
Q

in this type of HA, pain is like a band squeezing the head

A

tension

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6
Q

in this type of HA, you get pain nausea and visual changes ( migraine with aura)

A

migraine

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7
Q

what are some secondary HA caused by

A

sinus, fasting, infections, stroke, trauma, tumor, hydrocephalus, refractive disorders

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8
Q

what are some red flags for HA

A
  1. new type of HA over the age of 50
  2. HA increased frequency or severity
  3. HA wakes pt from sleep
  4. Onset of HA assoc with an underlying medical condition or systemic illness
  5. HA with neurological symptoms
  6. HA with papilledema
  7. HA with altered mental status
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9
Q

this the majority of all HA; dysfunction of pain perception; episodic or chronic changes; more common in women; CNS sensitization due to persistent myofascial input

A

tension type HA

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10
Q

signs of this type of HA include :bilateral, dull, band like tightness; lasts 4-6 hrs; no photophobia or phonophobia; doesn’t get worse with physical activity

A

Tension type HA

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11
Q

what are some causes of Tension HA

A

emotional of physical stress; depression and anxiety; working in awkward positions;; overuse of OTC analgesis

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12
Q

Tx for this type of HA include: OTC NSAIDS, caffeine, exercise, and stress reduction therapy

A

tension type HA

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13
Q

this type of HA affects females more than men; most prevalent age 25-55; 70% have immediate family Hx; Hx of childhood car sickness, benign vertigo ; strong correlation with depression and anxiety

A

migraines

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14
Q

what is the neurovascular theory of migraine pathophysiology

A

lowered threshold to stimuli leads to cortical hyperexcitability> cortical spreading depression activates trigeminal nerves and causes pain in dural blood vessels

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15
Q

T or F: migraines begin in the temporal lobe and move forward

A

F: begin in the occipital lobe

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16
Q

what are the diff migraine stages

A

prodrome, aura, attack, and postdrome

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17
Q

this migraine stage happens 1-2 days prior to attack; involves constipation , depression, diarrhea, drowsiness, and irritability

A

prodrome

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18
Q

this migraine stage happens immediately before attack ; usually visual

A

aura

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19
Q

this migraine stage is moderate to severe pain; several hrs to 3 days

A

attack

20
Q

this migraine stage is malaise and fatigue

A

postdrome

21
Q

what are some migraine triggers

A

stress, head trauma, weather or air pressure changes, bright lighting, meds , smoking, strong odors, fasting, red wine, hormone changes

22
Q

what are some foods that trigger migraines

A

tyramine ( yogurts); phenylethylamine ( chocolate, wine); Sodium nitrites, artificial sweeteners, caffeine, MSG, Alcohol, chocolate

23
Q

what is the 5,4,3,2,1 criteria for migraines

A

5 or more attacks; 4 hours to 3 days in duration; 2 or more of the following symptoms ( unilateral, pulsating, moderate or severe pain, aggravation by or causing avoidance of routine physical activity ); 1 or more of the following ( nausea or vomiting, and photophobia or phonophobia)

24
Q

what are the diff types of migraines

A

migraine w/o aura ( majority), migraine with aura, retinal migraines, childhood periodic syndromes, complication of migraines, probable migraines, chronic migraines

25
Q

signs of this type of migraine include :improves with sleep, progressivey worsening , unilateral, throbbing pain , nausea and vomiting, anorexia

A

migraine without aura

26
Q

T or F: migraines w/o aura increase the risk of stroke and MI by 25%

A

T

27
Q

this type of migraine is the classic type ; HA symptoms are the same as migraine w/o aura; aura precedes HA; can have aura w/o HA ( more common in men over 40) ;90% increased risk of stroke and 108% increased risk of stroke

A

migraine with aura

28
Q

what type of scotoma do you get with migraine with aura

A

scintillating scotoma

29
Q

how do scintillating scotomas come about

A
  1. initial paracentral scotoma
  2. , enlarging scotoma 7 mins later
  3. scotoma obscuring central vision 15 mins later
  4. break up of scotoma 20 mins later
30
Q

these types of migraines are transient, monocular visual disturbances ; usually brief, HA before or after the visual episode ; under age 40;

A

retinal migraines

31
Q

caused by vascular spasm which causes an interruption in the ciliary or retinal circulation; DDx is Amaurosis fugax

A

retinal migraines

32
Q

what are some ocular manifestations of migraines

A

aura, hemianopsia, horners syndrome, normal tension glaucoma

33
Q

this ocular manifestation is the most common cause of transient vision loss under age 45

A

auras

34
Q

this ocular manifestation is a persistent VF defects up to weeks after an attack ; VF loss can be permanent

A

hemianopsia

35
Q

this ocular manifestation is usually in older adults , association not causation

A

normal tension glaucoma

36
Q

what type of Tx would you do if the HA are more than 2 per month

A

prophylactic Tx

37
Q

what are the diff prophylactic Tx for HA

A

beta blockers, antidepressants, epilepsy meds, lithium, Ca channel blockers, Botox

38
Q

what are the diff abortive Tx

A

serotonin agents, cerebral vasoconstrictive agents, non constrictive abortive agents , antiemetic drugs ( Phenergan), general pain mgt

39
Q

this type of HA can have excrutiating,unilateral pain ( orbital, supraorbital or temporal); rare ( 80% are heavy smokers, 50% have Hx of ETOH use/abuse; attacks occur in clusters

A

cluster HA

40
Q

this type of HA can last for weeks or monthsl HA lasts 15-180 mins; can occur once every other day for 8x/day

A

cluster HA

41
Q

this type of HA involves changes to trigeminal pain processing; some autonomic features include nasal congestion, facial sweating, projectile lacrimation, conj redness, miosis and ptosis

A

cluster HA

42
Q

what are some Tx options for cluster HA

A

verapamil, lithium, divalproex, oxygen, and sumatriptan

43
Q

what are some ocular causes of HA

A

angle closure glaucoma, uveitis, keratitis, and scleritis, optic neuritis, refractice disorders and muscle imbalance, metastatic orbital tumors

44
Q

this is a sharp, stabbing, fleeting pain localized to one eye; occurs along CN V ; often a Hx of migraines; benign; cause unknown

A

ophthalmodynia periodica

45
Q

this is acute, unilateral mydriasis ( lasts for a few mins up to 1 week, may have light reaction, women more than men ; Hx of migraines;

A

benign episodic pupillary mydriasis

46
Q

this is assoc with blur, photophobia, HA

A

benign, episodic pupillary mydriasis

47
Q

this is pain in the trigeminal and faical nerve areas; ages 15-40 YO; more common in females; 5% of population ; originates from the jaw and Is worse than chewing; jaw clicks or locksl manage with dental devices or analgesics

A

TMJ syndrome

Medical Pathology (11 decks)

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