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Neuro Exam 3 > Headaches - Dr. Thomas > Flashcards

Headaches - Dr. Thomas Flashcards

1
Q 
The most common type of primary headache is:
A. Sinus
B. Cluster
C. Tension
D. Migraine
A

C. Tension

Sinus headache is secondary, not primary!

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2
Q

True or False: Tension headache is the least studied of the primary headache disorders, despite the fact that it has the highest socio-economic impact.

A

True (bc there isn’t a lot of money to be made on them since they can be treated effectively with OTC meds)

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3
Q 
\_\_\_\_\_ headache is characterized by bilateral location, pressing/tightening (non-pulsating) quality, mild to moderate intensity, not aggravated by routine physical activity/exertion, and there is no nausea, vomiting, photophobia or phonophobia.
A. Sinus
B. Cluster
C. Tension
D. Migraine
A

C. Tension

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4
Q

True or False: Migraine headache is considered a neurological syndrome and has a genetic component.

A

True

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5
Q

Migraine headaches are more common in ____.

A

Women

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6
Q

What is the difference between common migraine and classic migraine?

A

Common migraine = without aura

Class migraine = with aura

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7
Q

_____ headache is characterized by unilateral location, pulsating quality, moderate to severe pain intensity, aggravation by or causing avoidance of routine physical activity, and includes at least one of the following: nausea, vomiting, photophobia/phonophobia.

A

Migraine headache

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8
Q

Which is more common: Migraine with aura (classic migraine) OR migraine without aura (common migraine)?

A

Migraine without aura (common migraine)

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9
Q 
Which of the following is a secondary type of headache?
A. Sinus
B. Cluster
C. Tension
D. Migraine
A

A. Sinus

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10
Q

List the phases/stages of migraine headaches.

A
  1. Prodrome
  2. Aura (only in about 15-20% of patients)
  3. Headache
  4. Postdrome
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11
Q

Put the 3 primary types of headaches in order from most severe to least severe.

A
  1. Cluster headache
  2. Migraine headache
  3. Tension headache
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12
Q

_____ headache is considered one of the (if not THE) most painful syndromes to afflict humans, is characterized by severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting up to 3 hours if untreated, ipsilateral nasal congestion and/or rhinorrhea, eyelid edema, forehead and facial sweating mitosis and/or ptosis, and a sense of restlessness or agitation.

A

Cluster headache

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13
Q 
A patient is experiencing watery left eye, drooping eyelid, and runny nose. What type of headache is this likely to be?
A. Sinus
B. Cluster
C. Tension
D. Migraine
A

B. Cluster

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14
Q

What is the acute treatment of cluster headache?

A

Sumatriptan SC

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15
Q

The main prophylactic treatment for cluster headache is _____.

A

Verapamil

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16
Q

The older theory of migraines states that migraines are due to:
A. Spasming of cranial vasculature
B. Inflammatory mediators inducing pain (“cortical depression” model)

A

A. Spasming of cranial vasculature

17
Q

True or False: Migraines are likely due to spasming of cranial vasculature and inflammatory mediators as part of the “cortical depression” model.

A

True

18
Q

With the “cortical depression” model of migraines, you first get hyper excitation that starts in the ___ lobe, which can describe why some experience a visual aura, followed by a period of cortical depression.

A

Occipital

19
Q

The ___ nerve is believed to involved in the pain seen with migraines as well as cluster headaches.

A

Trigeminal

20
Q

Migraine has been described as “low ____ syndrome” because the platelet levels of it drop rapidly during the onset of a migraine and there is increased 5-HIAA excretion, which is a breakdown product of it, during attacks.

A

Serotonin

21
Q

The gold standard pharmacological treatment of migraines is _____.

A

Triptans

22
Q

Can NSAIDs be used for migraines?

A

Yes, they are somewhat effective, but not like ergotamine or triptans

23
Q

Ergotamine is an agonist at NE and serotonin subtypes 5HT1B and 5HT1D, which results in ______, thus stabilizing the spasming vasculature.

A

vasoconstriction

24
Q

Can caffeine be used to treat migraines?

A

Yes

25
Q

_____ is a combination product of caffeine and ergotamine used to treat migraine headaches.

A

Cafergot

26
Q

the main side effect of triptans is ____.

A

CV effects

27
Q

Can triptans cause nausea/vomiting?

A

NO! Actually have anti-N/V properties.

28
Q

Where do triptans work in terms of receptors?

A

Serotonin receptor subtypes 5HT1B and 5HT1D (DOESN’T work at NE, unlike ergotamine).

29
Q

____ is/are used to treat migraines and work as 5HT1B and 5HT1D agonist to contract cranial vasculature as well as decrease inflammatory response elements such as CGRP.

A

Triptans

30
Q

True or False: Triptans carry substantial cardiovascular risk and can exacerbate CV problems in patients with preexisting CV issues.

A

True

31
Q

______ is found in ~40% of trigeminal nerve branches which innervate meningeal blood vessels and can propagate pain to postsynaptic neurons.

A

Calcitonin Gene-Related Peptide (CGRP)

32
Q 
All of the following can be used for prophylactic treatment of migraines EXCEPT:
A. Beta-blockers
B. ACE-inhibitors
C. Calcium channel blockers
D. Anti-convulsants
E. Anti-depressants
A

B. ACE-inhibitors

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