Headaches

Question 1

Most important question when diagnosing headaches?

Answer 1

Timing!

Question 2

HA worse in morning; gone with activity; generalized and throbbing

Answer 2

Hypertension

Question 3

HA worse in the morning; toxic; secondary symptom from “hangover”

Answer 3

Metabolic HA

Question 4

2 types of headaches that are ‘worse in the morning’?

Answer 4

Hypertension and Metabolic

Question 5

HA that is generalized, CONSTANT, cant’ flex because nuchal rigidity causes pain with all movement. (+) Brudzinski’s and Kernig’s

Answer 5

Meningitis

Question 6

HA with 15-45 seconds of pain; affects alcoholics due to low B vitamins; travels ear to face

Answer 6

Trigeminal Neuralgia

Question 7

HA with 15-45 seconds of pain; travels ear to throat

Answer 7

Glossopharyngeal Neuralgia

Question 8

HA with 15-45 seconds of pain; travels ear to back of neck

Answer 8

Suboccipital Neuralgia

Question 9

HA with 15-45 seconds of pain is always a form of _____?

Answer 9

Neuralgia

Question 10

HA is Progressive (gets worse); NOCTURNAL (awareness at night); Medicine ineffective; Worse with position change; Personality changes

Answer 10

Tumor

Question 11

Young females (menses), familial HA
Tyramine and alcohol trigger
Causes nausea and vomitting
Aura, 3-5 days

Answer 11

Classical Migraine

Question 12

No aura, 3-5 day HA

Answer 12

Common Migraine

Question 13

Geriatric (over 50yo); hallmark is Polymyalgia rheumatica; occurs in both sexes; CONSTANT; hypertension history; Increased ESR over 90 mm/hr; these people stop moving because it hurts every time they try and move around.

Answer 13

Temporal Arteritis (aka Giant Cell)

Giant Cells get stuck/clog up capillary beds

Question 14

HA affects primarily males; piercing; Histamine (allergy based); Unilateral; lasts 1-2 HOURS; Rhinorrhea and congestion; Seasonal and recurring; Wake up after 2 hours of sleep.

Answer 14

Cluster HA

Question 15

Muscle spasm; bilateral, band-like feeling; stress-related; occurs in AFTERNOON

Answer 15

Tension HA

Question 16

PPW painful spasm of SCM, causing head to be healed in rotation with slight Flexion.

Answer 16

Torticollis (CN XI)

Question 17

Three muscles affected by Torticollis?

Answer 17

SCM - ipsilateral lateral Flexion, contralateral rotation
Splenius Capitus - ipsilateral lateral Flexion, ipsilateral rotation
Trapezium - extension

Question 18

Worst HA ever felt; SUDDEN paralysis; Neuro deficit more than 24 hours; ‘FAST’ face, arm, speech, time = take baby aspirin and call ambulance

Answer 18

CVA

Question 19

POST-TRAUMA HA; Battle sign present; CSF

Answer 19

Basal Skull Fracture

Question 20

HA occurs 2 hours POST-PRANDIAL (post meal); FBS, FTT, A1C; Hyperinsuline

Answer 20

Hypoglycemia

Question 21

Biomechanical; PREDICTABLE; Dental work, trauma, stress, bruxism (grinds teeth).

Answer 21

TMJ