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CPD Fall 2014 > Quiz 1: Head and Nose > Flashcards

Quiz 1: Head and Nose Flashcards

1
Q

What are Red Flag symptoms indicating a person needs immediate medical attention?

A

Unconsciousness, alt. mental status, convulsions, persistent HA, extremity weakness, bleeding/fluid from ear(s), loss of hearing

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2
Q

Post-concussion syndrome

1) duration
2) symptoms

A

1) symptoms can persist for weeks to years

2) HA, fatigue, anxiety, dizziness, memory & attention problems, sleep disturbance, irritability, N/V

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3
Q

What percent of US population seeks medical help for HA?

A

5-10% of total pop; 20% kids have significant HA

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4
Q

Types of primary HA

A

Migrane, tension-type HA, cluster HA

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5
Q

Of primary HA, which is least common?

A

cluster

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6
Q

What percent of all HA are primary HA?

A

90%

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7
Q

What is meant by Secondary HA?

A

Caused by underlying medical condition

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8
Q

What are some causes of secondary HA?

A

Head and neck trauma, cranial or cervical vasc. disorders (hematoma, hemorrhage), non-vasc. intracranial disorders (high/low CSF pressure, infection (meningitis or systemic), disorders of homeostasis, substance abuse/withdrawl, psychiatric conditions, cranial neuralgia, iatrogenic

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9
Q

What are causes related to these S/Sx of Secondary HA
A. Sudden onset of new HA or “worst HA ever”
B. Fever
C. Weakness, clumsiness, postural instability
D. Onset w/ exertion, coughing, sex, valsalva

A

A. Subarachnoid hemorrhage
B. Infection
C. Focal brain disease
D. Mass, subarach. hemorrhage

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10
Q

What are causes related to these S/Sx of Secondary HA
A. Drowsiness, confusion, memory loss
B. Progressive vision loss
C. Chronic malaise myalgia, arthalgia

A

A. Infx, mass, subdural hematoma
B. Tumor, inc ICP, MS, Lyme, glaucoma, arteritis
C. Temporal arteritis, collagen vasc. dz, Lyme

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11
Q

T or F: Additional causes of secondary HA
A. Low BP
B. Headache is the same intensity every time
C. Metabolic imbalance (hypoglycemia, thyroid)
D. Focal neurological signs
E. CSF rhinorrhea

A 
A. False, high BP
B. False, progressively worsening
C. True
D. True
E. True
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12
Q

Vasc or Non-vasc HA?
A. Pain is throbbing or pounding/sharp
B. Pain is steady, constant, dull
C. Rapid changes in artery size from spasm/contraction

A

A. Vasc
B. Non-vasc
C. Vasc

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13
Q

Vasc or Non-vasc HA?
A. Examples: HTN, exertion, hangover
B. Examples: Tension-type, TMJ, brain tumor
C. Examples: Sinus/dental infx, inner/middle ear
D. Examples: Migrane, cluster, fever

A

A. Vasc
B. Non-vasc
C. Non-vasc
D. Vasc

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14
Q

What are Red Flags that you may get upon taking a history for HA that would indicate the patient needed to go to the ER?

A

Onset after age 50+ or sudden onset
Incr. freq. and severity
Pain moves to lower neck and thoracic spine; lower back
First or worst HA
History of head trauma, HIV, cancer
Any change in mental status, personality, level of consc.

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15
Q

What is the most important exam during the physical exam for HA?

A

Fundoscopic exam

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16
Q

What is done during the physical exam for a HA?

A

vitals
head and neck (carotid/temporal a. pulsations, cervical ROM, tenderness, palpate cranium, jaw, neck, sinus, perform oral and ear exam)
Neuro exam (CN, motor/sensory, reflexes, coord.)
fundoscopic exam

17
Q

What are the Red Flags that might be found during the physical exam?

A

Fever, neck stiffness/rigidity, papilledema, focal neuro signs, signs of systemic illness or infx

18
Q

Features of migranes

A

recurrent, variable (intensity, freq, duration), usually unilateral, anorexia, N/V, maybe aura, photophobia, wipes you out.

19
Q

What is the most common type of HA? Second?

A

Tension-type, then migrane

20
Q

Describe epidemiology of migranes

A

10-20% of US pop suffers
F:M 3:1
First attack often in childhood

21
Q

Co-existing conditions associated with migranes

A

Epilepsy, asthma, sleep disorders, hemorrhagic telangiectasia, Tourettes, Raynauds, familial dyslipoproteinemias, chronic fatigue, depress/anx, ischemic stroke, HTN, atrial septal defect

22
Q

Triggers for migranes

A

Stress, hormones, hypoglycemia, loss of sleep, change in weather, odors/lights/smoke, exercise, food intolerance/allergy, tyramine containing foods (antipasto)

23
Q

What are the two main categories of migranes?

A 
With aura (classic)
Without aura (common)
24
Q 
Do the following describe migranes with or w/o aura?
A. Must have had at least 5 attacks
B. HA must last 4-72 hrs
C. Dysphagia - speech disturbance
D. Photo/phono- phobia
A

A. W/out aura
B. Both, but with aura must be preceded by aura
C. With aura
D. Both

25
Q

Do the following describe migranes with or w/o aura?

A

x

26
Q

Do the following describe migranes with or w/o aura?

A

x

27
Q

What are prodromal symptoms? Examples?

A

Occur hrs/days before migrane

hyperactivity, lethargy, depression, cravings, freq. yawning

CPD Fall 2014 (12 decks)

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