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MS4 - Neurology > Headaches > Flashcards

Headaches Flashcards

1
Q

Causes of acute headaches

A

VICIOUS

Vascular
Infection
Compression
ICP
Ophthalmic
Unknown
Systemic

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2
Q

Vascular causes of acute headaches

A

Intracranial haemorrhage

Infarction

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3
Q

Infection causes of acute headache

A

Meningitis

Encephalitis

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4
Q

Compression causes of acute headache

A

Hydrocephalus

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5
Q

Ophthalmic causes of acute headache

A

Acute glaucoma

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6
Q

Systemic causes of acute headaches

A

HTN: Phaeochromocytoma
Infection: sinusitis
Toxins: CO

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7
Q

Causes of chronic headaches

A

MCT DINGS

Migraine
Cluster headaches
Tension headaches

Drugs
ICP
Neuralgia (trigeminal)
Giant cell arteritis
Systemic

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8
Q

Drug causes of chronic headaches

A

Analgesics

Caffeine

Vasodilators

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9
Q

Systemic causes of chronic headaches

A

HTN

Uraemia

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10
Q

Subarachnoid haemorrhage features

A

Thunderclap headache
Sudden onset
Occipital

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11
Q

Tension headache features

A

Bilateral
Band like
Non pulsatile

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12
Q

Cluster headache features

A

Rapid onset
Unilateral
Severe pain around one eye

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13
Q

Sx of cluster headache

A

Red, watery eye
Nasal congestion
Miosis +/- ptosis

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14
Q

Length of cluster headache attacks

A

15 mins - 3 hrs

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15
Q

Length of cluster headache clusters

A

4 - 12 wks

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16
Q

Length of cluster headache remission

A

3 months - 3 yrs

17
Q

Acute treatment of cluster headache attacks

A

100% O2
Triptans (Sumitriptan)

18
Q

Prevention of cluster headache attacks

A

Verapamil
Topiramate
Lithium

19
Q

Trigeminal neuralgia features

A

Male > 50 yrs

Unilateral stabbing pain

Trigeminal division distribution (usually V2/3)

20
Q

Secondary causes of trigeminal neuralgia

A

Compression (aneurysm)
MS
Zoster

21
Q

Triggers of trigeminal neuralgia

A

Washing area
Shaving
Eating
Talking

22
Q

Medical mx of trigeminal neuralgia

A

Carbamazepine
Lamotrigine
Gabapentin

23
Q

Surgical mx of trigeminal neuralgia

A

Microvascular decompression

24
Q

Giant cell arteritis
Age
ESR
Treatment

A

Age > 60 yrs
ESR > 60
Prednisolone 60 mg

25
Q

Giant cell arteritis presentation

A

Unilateral scalp tenderness
Thickened pulseless temporal artery
Jaw claudication
Amaurosis fugax
Sudden blindness

26
Q

Association of giant cell arteritis

A

Polymyalgia rheumatica

27
Q

Giant cell arteritis investigations

A

ESR > 60
Raised PLT
Raised ALP
Decreased Hb
Temporal artery biopsy

28
Q

Treatment of giant cell arteritis

A

Prednisolone 60 mg PO OD 5-7d

PPI

Bisphosphonate

29
Q

Migraine risk factors

A

F
Obesity
Patent foramen ovale

30
Q

Types of migraine

A

Aura + Headache (classic)
Isolated aura
Headache w/o aura (common)

31
Q

Migraine triggers

A

CHOCOLATE

CHeese
OCP
Caffeine
alcohOL
Anxiety
Travel
Exercise

32
Q

Migraine prodrome timing

A

Preceed migraine by hrs - days

33
Q

Sx of migraine prodrome

A

Yawning
Cravings
Changes in sleep, appetite or mood

34
Q

Migraine aura timing

A

Preceed migraine by mins

35
Q

Sx of migraine aura

A

Visual - distortion, zig zags, hemianopia
Paraesthesia
Speech
Motor

Teicophosia

Scintillating scotoma

Fortification spectra

36
Q

Migraine w/o aura diagnostic criteria

A

5+ headaches lasting 4-72 hrs
+ Nausea/vomiting or phono/photophobia
+ 2+ out of :
- Unilateral
- Pulsating
- Interference with normal life
- Worsened by routine activity

37
Q

Treatment of an acute migraine episode

A

1) Paracetamol + metoclopramide
2) NSAID + metoclopramide
3) Rizatriptan (triptans)
4) Ergotamine

38
Q

Prophylaxis of migraines

A

Avoid triggers

1) Propanolol, topiramate
2) Valproate, pizotifen, gabapentin

39
Q

Mode of action of triptans

A

5-HT receptor agonist

MS4 - Neurology (11 decks)

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