Quiz 1 headache part 2 Flashcards
causes of SAH
-traumatic or spontaneous from berry aneurysm or arteriorvenous malformation
what normally has not onsent
berry aneurysm
symptoms of SAH
thunderclap, impaired consciousness and meningismus (neck pain)
what identifies the hemorrhage source?
cerebral arteriography
what finds the bleed
dye from the ct, this is the first step
-may not be on ct within first 24 hours then you would follow up in 2 weeks
-ct may also show midline shift
concerns of SAh
-rebleed and development of hydrocephalus
-sentinal bleed can rebleed which can be fatal
-cardiac arrythmia and pulmonary edema
hydrocephalus
csf in the ventricles builds up
sentinal bleed
minor bleed before a major episode
risk of giant cell arteritis
going blind due to the inflammation in the temporal artery
symptoms of temporal arteritis
-temporal artery pain, swelling, tender, red
-vision changes, fever, weight loss, anorexia, polymalgia rheumatica
diagnostics of temporal arteritis
ESR > 50 *not a definitive test just tells us there is inflammation
-tempral arterial biopsy to look for multinucleated cells and inflammation
temproal arteritis treatment
-steroids
-take biopsy within 2 weeks of steroids
temporal arteritis demographics
-rare before 50
bacteria acute meningitis is?
severe with purulent CSF, fast progression and fatal
aseptic meningitis
milder, self-limited, viral, fungal, bacterial
what meningitis needs immediate isolation?
Neiserria meningitis
symtoms of meningitis?
fever, headache, nuchal ridgidity, chills, lethargy, co ma, photophobia, rash, seizure, hyptothermia, gray skin
what is NOT painful with meningitis?
rotation and extension of the neck
meningitis tests?
-meningismus (flex forward)
-kerning (cant straighten legs)
-brudzinski sign
-tripod position
bacterial meningitis has?
rash/ petechiae
how to identify meningisits bacteria
-LP then gram stain, differential count, measure glucose/ protein etc to find correct antibiotic
pt has a histopry of using antibiotics to treat infection they could have?
aseptic meningitis because it was subdued by the antibiotic use
postraumatic headache onset?
within days of injury typically one day but will gradually subside normally
type of pain for postraumatic?
constant dull ache with localized, lateralized or general throbbing
t or f postraumatic headache has nausea/ vom
true
covid headache symptoms:
throbbing, pressure whole head
-worsens with activity
-fever body ache etc (covid symptoms)
what meds cause med overuse headahce?
NSAIDS or Opiods
criteria for med overuse?
15 days of headache in last 3 months with regular medication overuse> than 3 months
vom before pain means?
intracranial lession headache
what causes increase ICP
intracranial lession headache
deep dull ache, worse with activity, nausea vom, sleep disturbance, seizure
intracranial lession headache
key symptom of itnracranial lession headache?
personality change and worsens with recumbancy
what may make activity triggered headache better?
LP
demographic of trigeminal nerve/ facial pain
women, MS, neoplasia, mid/late life
what is episodic pain with burning and stabbing
trigeminal nerve
t or f exams are negative with trigeminal nerve pain
typically true
oxcarbazepine and carbamazepine and NSAIDS treat?
trigeminal nerve
what causes glaucomma
schlemm canal narrows for fluid cant enter back to vascular circulation
what glaucomma is medical emergency
acute angle glaucomma
severe pain, face pain, halo lights, nausea/ vom. abdominal pain, what am I?
glaucomma
glaucomma treatment?
timolol (beta blocker), pilocarpine, and acetazolamide (carbonic anhydrase inhibitor)
glaucomma eye apperance
red, cloudy, pupil not moving/ changing and slightly dialtes with high intraocular pressure
postherpetic neuralgia
shingles and treat with acyclovir
TMJ can be cause by
teeth grinding send to dentist
