HEENT Flashcards
What is HEENT?
Head, Eyes, Ears, Nose, and Throat
Describe SCHOLAR
S–> Symptoms
C–> Charactersitics
H–> History
O–> Onset
L–> Location
A–> Aggravating Factors
R–> Remitting Factors
Head: What are the three headaches?
- Migraine
- Cluster Headache
- Tension Headache
Is there an external cause? No.
- Migraine
- Tension
- Cluster
Is there an external cause?
Yes
- Infection
- Brain tumor
- stroke
- Trauma
What are the factors of a migraine headache?
- More common in women than men
- greater than 50% of those affected report severe disability and need for bed rest during an attack
- Highest prevalence between ages of 18 to 44
- Mechanism is not entirely understood
What are the main migraine symptoms?
- Photophobia
- Phonophobia
- Onset: Sudden
- Duration: 4-72 hours
- Recurring episodes of throbbing head pain
- Frequent unilateral
- Can be associated with nausea, vomiting, and senstivity to light or sound.
What is a Migraine “Aura”?
- Experienced by 25% of patients
- Occurs prior to or at the onset of the migraine
- Typically evolves over 5 minutes or longer and often lasts less than 60 minutes
- Symptoms:
- Paresthesia or numbness involving arms and face
- Changes in vision/blind spots/flashes of light
- Sensory changes
What are absortive therapies that will help with migraines?
- Ergots
- Triptans
- CGRP antagonists
- NSAIDS/Analgesics
Referral required
What are preventative therapies for migraines?
- Beta Blocker
- Anti-eipleptic Agents
- CGRP antagonists
- Biologics
- Botulism toxin (Botox)
What are non-pharmacologic treatments for migraines?
- Rest/sleep in dark, quiet environment
- Ice pack
- Avoid triggers
What is the most common type of headache?
Tension headache
Are tension headaches more common in males or females?
Females
What is the least studied of all headache types?
Tension headache
What is the defining characteristic of a tension headache?
Episodic or chronic nature.
What are the key characteristics of tension headaches?
- coexisting migraine
- depression
- anxiety
- poor stress management
What are the symptoms of a tension headache?
- Onset: Gradual
- Duration: Variable, hours to days
- Bilateral dull, non-pulsatile tightness, or pressure
- Described as having a “hatband” pattern
- +/- Photophobia or Phonophobia
- Less debilitating than a migraine
What are acute treatment options for tension headaches?
- Can treat OTC
- Max number of days for acute treatment= 15 days/month
- Examples: Aleve, Excedrin, Motrin, Tylenol
Who are most affected by cluster headaches?
- Men
- 85% of individuals with cluster headaches are tobacco smokers or have a smoking history.
What severity is a cluster headache?
Most severe, but least common primary headache disorder
What are the potential causes of a cluster headache?
- Hypoxia
- Genetic predisposition
- Hypothalamic dysfunction
Describe the cluster headache symptoms.
- Onset: Sudden
- Duration: 15 mins to 3 hours
- Commonly at night and frequently in the spring and fall
- Excruciating, penetrating pain that is deep, non-pulsating, behind the eye
- Cranial autonomic symptoms: Lacrimation, nasal stuffiness, rhinorrhea, eyelid edema, facial sweating.
What are common treatments for cluster headaches?
Pharmacological treatment is oxygen, but referral is required.
What are non-pharmacological treatments for ALL headache types?
- Avoiding stress and triggers
- Exercise, massages, stretching, sleep hygiene, etc.
- Heat or cold packs