Minicase - HA Flashcards
1
Q
W/u for migraine (4)
A
- MRI brain (intracranial neoplasm)
- CT head
- CBC
- ESR
2
Q
W/u for cluster headache (4)
A
- MRI brain (intracranial neoplasm)
- CT head
- CBC
- ESR
3
Q
W/u for temporal arteritis (6)
A
- temporal artery biopsy
- ESR (temporal arteritis)
- CRP (temporal arteritis)
- CBC
- doppler U/S-carotid
- MRI brain (intracranial neoplasm)
4
Q
W/u for acute sinusitis (3)
A
- CBC
- XR sinus
- CT sinus
(ddx inccludes tension headache, meningitis in which case you’d want the meningitis w/u below)
5
Q
W/u for tension HA (4)
A
- lytes
- CBC
- MRI brain (neoplasm)
- LP w/ CSF analysis (pseudotumor cerebri w/ openig pressure)
6
Q
W/u for SAH (8)
A
- CT head w/o contrast
- LP w/ CSF analysis and opening pressure
- CBC
- PT/PTT/INR
- Urine toxicology
- Digital subtraction angiography
- MRI brain
- CT angiography
7
Q
W/u for meningitis (6)
A
- LP w/ CSF analysis, opening pressure, gram stain, PCR, culture)
- BCx
- CBC
- CT head w/o contrast (SAH, intracranial abscess)
- MRI brain
- PT/PTT/INR (SAH)
8
Q
W/u for pseudotumor cerebri (6)
A
- Urine hCG
- LP w/ CSF analysis and opening pressure
- dilated fundoscopy examination
- funduscopic eye exam
- MRI brain (intracranial neoplasm)
- visual field testing
9
Q
W/u for trigeminal neuralgia
A
- MRI brain
- CBC
- ESR
(ddx includes: cluster HA, TMJ disorder, temporal arteritis)
10
Q
Migraine hx findings (7)
A
- HA
- episodic
- throbbing nature
- unilateral
- duration (hours to days, I think)
- neurologic symptoms (N/V, aura, photophobia)
- alleviation by rest/dark room
11
Q
Cluster hx findings (6)
A
- HA
- gender and age- young male
- unilateral
- rhinorrhea, eye tearing and redness
- episodic and same time at night
- duration (~45 min)
12
Q
Tension hx findings (5)
A
- HA
- bilateral
- squeezing nature
- episodic
- associated with stress
13
Q
Temporal arteritis hx findings (10, exam included as 1)
A
- HA
- elderly
- episodic
- unilateral
- blurred vision
- temporal location
- weight loss
- jaw pain when chewing
- shoulder, hip pain
- Exam: temporal TTP, reduced visual acuity
14
Q
Acute sinusitis hx findings (6)
A
- HA
- frontal HA
- fever
- nasal dicharge
- worsen when bend forward
- hx of allergies
15
Q
SAH hx findings (7)
A
- HA
- severe
- acute
- vomiting
- confusion/AMS
- FNDs (hemiplegia)
- nuchal rigidity
16
Q
Meningitis hx findings (6)
A
- HA
- confusion
- photophobia
- high fever
- nuchal rigidity
- consider exposures (dorms, army, etc)
17
Q
Pseudotumor cerebri hx findings (8)
A
- HA
- obesity
- female gender
- blurred vision
- pulsatile in nature
- N/V
- OCP use
- frequency - daily for 2-3 wks
18
Q
Trigeminal neuralgia hx findings
A
- HA
- elderly
- unilateral
- cheek location
- triggered by touch
- frequency - daily for month
- duration - 1-2 minutes
- stabbing and electric character
19
Q
What is TMJ (temporomandibular joint) disorder?
A
- TMJ joint dysfunction
- crepitus with jaw movement
- pain with chewing
20
Q
HA hx question nemonnic
A
- OPQRST
- AT&T WIRELESS
A - aura T - timing (in OPQRST) N - N/V T - tearing, eye symptoms W - wt loss I - injury E - estrogen exposure (OCPs) L - leg (jt) pain E - energy level (consititutional symptoms) S - stress S - speech difficulties
21
Q
Basic HA differential (9)
A
- migraine
- tension
- cluster
- pseudotumor cerebri
- sinusitis
- meningitis
- temporal arteritis
- SAH
- intracranial mass