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Emergency Medicine > Headaches + Head Injury > Flashcards

Headaches + Head Injury Flashcards

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1
Q

Causes of venous sinus thrombosis

A

Pregnancy, OCP, had injury, dehydration, malignancy

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2
Q

Types of venous sinus thrombosis + S+S of each

A

Sagittal - headache, vomiting, seizures, papilloedema
Transverse - headache, mastoid pain, focal CNS, seizures
Sigmoid - sinus, cerebellar signs
Cavernous - eye symptoms
Lateral sinus - 6/7th nerve palsy

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3
Q

Investigations for ?venous sinus thrombosis

A

CT or MRI T2
Delta sign
LP

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4
Q

Presentation of temporal arteritis

A

Headache, tenderness, weight loss, night sweats, jaw, polymyalgia, claudication, vision loss, SOB
Histology: skips sections of artery

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5
Q

Fundoscopy findings for temporal arteritis

A

Pale papilloedema

Ischaemic disc = pale, waxy, elevated, splinter haemorrhages

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6
Q

Investigations for temporal arteritis

A

FBC (normocytic anaemia), LFTs, ESR, CRP

Temporal artery biopsy - diagnostic

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7
Q

Management of temporal arteritis

A

Prednisolone 60mg

Low dose aspirin + PPI

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8
Q

Complications of temporal arteritis

A

Aneurysms
Blindness
Dissections
Risk of stroke

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9
Q

What is a minor, mod + severe GCS score?

A 
Minor = 13-15
Mod = 9-12 
Severe = <8
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10
Q

What to check for in head injury?

A

Glucose
GCS
External signs of injury
Pupils - equal, reactive to light

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11
Q

What are the 5 external signs of head injury?

A 
Panda eyes
Battle sign 
CSF leak 
Blood behind TM 
Abrasions/ bleeding
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12
Q

Most appropriate IV fluid in head injury?

A

Mannitol

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13
Q

RF for migraines

A

Females
Stress, hormones, weather, alcohol, smoking
IBS

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14
Q

Management of migraines

A 
NSAIDs - Ketorolac 
Triptans (serotonin agonists)
Proclorperazine 
Diphenyhydramine 
Dexamethasone 
Haloperidol, metoclopramide, ergotamine
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15
Q

S+S of tension headache

A

Bilateral tightening headache
Photophobia
Stiffness

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16
Q

Management of tension headache

A

NSAIDs
Caffeine
Butalbital

Prophylaxis:
TCA/ mirtazapine/ venlafaxine
Anticonvulsants
CBT

17
Q

S+S cluster headache

A

Unilateral headache, multiple per day

18
Q

Management of cluster headaches

A

Triptans
Intranasal lidocaine

Prophylaxis:
verapamil
prednisone
lithium

surgery to block greater occipital nerve

19
Q

What are the indications for CT after head injury?

A 
GCS <15 2h after injury 
Suspected open or depressed skull fracture 
Any sign of basal skull fracture 
Vomiting >2 episodes 
Age >65 
Amnesia before impact >30 mins
Dangerous mechanism

Emergency Medicine (24 decks)

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