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Neurology > Primary Headaches > Flashcards

Primary Headaches Flashcards

1
Q

What is the most likely cause of a head ache at the Temple, front of ears

A

TMJ

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2
Q

What is the most likely cause of a head ache behind brow bone and/or cheekbones

A

Sinus

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3
Q

What is the most likely cause of a head ache in and around one eye

A

Cluster

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4
Q

What is the most likely cause of a head ache like a band squeezing the head

A

Tension

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5
Q

What is the most likely cause of a head ache with pain, nausea, and visual changes, unilateral

A

Migraine

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6
Q

What is the most likely cause of a head ache with pain at the top and/or back of the head

A

Neck

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7
Q

What are some headache red flags

A 
change in progression or pattern
first/worst HA
new headache in pt > 50
new headache in pt w cancer
Neuron Sx lasting > 1 hr
Abrupt onset attacks - awaken from sleep
triggered by exertion, sex, valsalva
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8
Q

What does Nuchal rigidity imply (2 things)

A

Meningitis

Subarachnoid hemorrhage

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9
Q

How are migraines related to the menstrual cycle?

A

Migraines tend to develop in menarche
Persist episodically, interrupted during pregnancy

Maximal frequency in the 5 days before and after menses

taper off after menopause

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10
Q

What part of the brain causes headaches in Migraines?

A 
Trigininocervical complex (TCC)
-stimulates dural vasculature = throbbing

TCC outputs via CN V to facial structures

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11
Q

What 4 substances inhibit nociceptive transmission in migraines?

A

Endocannabinoids
5-HT
GABA
Orexin A inhibit

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12
Q

What 2 substances facilitate nociceptive transmission in migraines?

A

Glutamate

Orexin B

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13
Q

How do Migraines cause Nausea and Vomiting

A

transient dysfunction of hypothalamic nuclei
= hypersensitivity to dopamine D2 receptors
= stimulation of the medullary emetic center

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14
Q

What foods/meds can cause migraines?

A

Chocolate, Sharp cheeses, preserved meats, red wines

Estrogens

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15
Q

What is the med treatment of <5 Migraines per month?

A

Triptans (Sumatriptan)

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16
Q

What is the med treatment of <5 Migraines per month?

A 
Daily Prophylaxis:
B-blockers
tricyclic antidepressants
Calcium channel blockers
Anticonvulsants (valprroate, topiramate, zonisamide)
17
Q

What parts of the brain mediate Cluster headaches?

A
  1. Hypothalamus (Orexin A and B)

2. Dorsal rostral Pons

18
Q

What is the tx of acute Cluster headaches?

A

ergotamines
triptans
oxygen inhalation

19
Q

What more serious diseases do tension headaches mimic (have to check for these)

A

mimics brain tumors, temporal arteritis

20
Q

What is the criteria for chronic headache?

A

HA occure >15 days/month for > 3 months

Neurology (27 decks)

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