Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RTS > RTS CNS > Flashcards

RTS CNS Flashcards

1
Q

Symptoms for migraine headaches

A

“POUND”
Pulsatile quality or severe throbbing pain
hOurs (duration of 4-72 hours)
Unilateral pain (70% of cases) sometimes bilateral
Nauseating or vomiting
Disabling intensity - sufferers often have to sit in a dark quiet room
“PUPIL”
P=Pain around sinus area, trigeminal nerve becomes inflamed which can radiate to teeth and jaw
U=Unilateral location
P=Physical activity worsens headache, Photophobia (light sensitivity), Phonophobia (sound sensitivity)
I=Inhibits daily activity when present
L=Location: temporal region of head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Red flag signs for headaches or secondary headaches which are very serious

A

“SNOOPY”
Systemic signs and disorders (fever, weight loss)
Neurologic symptoms (abnormal signs such as confusion, impaired alertness or consciousness)
Onset sudden, Older anyone >50 yo, Occipital (back of head) headache in children
Onset in thunderclap presentation
Previous headaches: new, worst, different Papilledema, pulsatile tinnitus, positional provocation, precipitated by exercise
Younger age, child under 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Important questions to ask for a headache

A 
AT&T WIRELESS
Aura
Timing
Nausea/vomiting
Tearing and any other eye symptoms
Weakness/numbness
Injury
Runny nose during the attack
Estrogen exposure (OCPs)
Leg (joint pain)
Energy less
Stress
Speech difficulties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are cluster headaches?

A

“CLUSTER”
C – Conjunctival injection (bloodshot eyes). Conjunctival injection = A popular term for eyes that appear red due to dilation of the conjunctival vessels overlying the sclera Can occur every year usually similar time of the year (commonly spring & autumn)
L – Lacrimation, nasal congestion or rhinorrhea, forehead and facial sweating, miosis or ptosis Bouts can last 4-12 weeks at a time
U – Unilateral or ipsilateral - (the side affected can vary from time to time) pain is usually centered over one eye/ temple/ the forehead
S – Severe or very severe unilateral orbital, supraorbital, or temporal pain lasting 15 to 180 minutes if untreated
T – Triptan injection work. Oxygen and CCB work too.
E – Eyelid drooping (ptosis) or eyelid swelling.
R – Restlessness or agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Differential diagnosis for headache

A

Mnemonic: MM IT ACHES
Migraine
Meningitis, Medications
Increased intracranial pressure (tumours)
Tension headache, Temporal arteritis, Trigeminal Neuralgia
Arteriovenous malformations
Cluster headache
Hypertension, Hemorrhage
Eye disorders (Glaucoma), refractory error, exertional
Sinusitis, Sub-arachnoid hemorrhage, Systemic illnesses, Seizures, pSeudotumor cerebri

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What medications are used to treat a migraine?

A

Treatment of migraine mnemonic: NSAiDs
N: NSAIDS like Naproxen, Aspirin, Ibuprofen, Diclofenac
S: Sumatriptan (And other Triptans such as rizatriptan, eletriptan, almotriptan, zolmitriptan, naratriptan, and frovatriptan).
AiDs: Antiemetic/dopamine receptor antagonists: Chlorpromazine, prochlorperazine maleate 3mg, and metoclopramide
Ds: Dihydroergotamine and ergot derivatives
Treatment Mnemonics Acute management = TEA
T = Triptan
E = Ergotamine
A = Aspirin & other NSAIDs, Acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can trigger a migraine?

A 
CHOCOLaTE
Ch – chocolate
O – Oral contraceptive
C – caffeine (or withdrawal)
Ol – alcohol
T – travel
E – exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a migraine?

A

Migraine can be memorized by mnemonic: MIGRAINE
M = Males are less affected (Most patient are females), with aura warning signs before migraine begins (seeing flashing light/zig-zag lines)
I = Ion channel dysfunction causing a spreading front of cortical depolarisation (excitation) followed by hyperpolarisation (depression of activity) – pathogenesis
G = Genetic predisposition
R = Recurrent headache (Prophylactic treatment needed if > 3-4/month)
A = Aura (in 20% case), without aura migraine occurs without warning signs
I = Ilitriptan, sumatriptan, rizatriptan (Triptan) etc are the treatment of severe attack, not respond to paracetamol/NSAIDs
N = Nausea & vomiting
E = Ergotamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What medications are used for migraine prophylaxis?

A

When needed: If > 3-4 attacks/month
Mnemonic: ABCDE
A = Antidepressants (amitriptyline, venlafaxine) avoidance of triggers e.g. OCP, Stress, HRT containing estrogen
B = Beta blocker, metoprolol, timolol, propranolol (80-160 mg daily, in a sustained-release preparation),
C = Calcium channel blockers (less effective) verapamil (80-160mg daily), flunarizine, antiConvulsants (valproate, topiramate)
D = Depression medication, i.e. Tricyclic anti-depressant such as amitriptyline 10-50 mg at night, dosulepin
E = Epilepsy medication, Na valproate (300-600 mg/day), Topiramate (50-100 mg/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the commonly used medications for migraine in practice?

A

Practically commonly used drugs are BAT
Beta Blockers (Beta blockers and Calcium channel blockers)
Antidepressants (TCAs and SSRIs)
Topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you diagnose migraine without aura?

A 
"AUSTIN"
Activity aggravates the headache
Unilateral location
Sensitivity to light and/or sound
Throbbing
Intensity moderate/severe
Nausea/vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some preventative drugs used in migraine?

A

BATS
Beta blockers
Anticonvulsants (GTV) gabapentin, topiramate, valproate
Tricyclic antidepressants
Serotonergic drugs (Sumatriptan 50mg (imigran recovery tablet) - Serotonin agonist (5-HT1D) that relieves migraine by causing blood vessels in the brain to narrow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the features of a migraine?

A 
"EAT FUN"
E=Episodic
A=Aura - zigzag lines
T=Throbbing headache
F=Family history/F(p)hoto-phobia
U=Unilateral
N=Nausea and vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the classification of a headache?

A

“VITAMIN”
V=Vascular: migraine, cluster, toxic vascular, hypertensive
I=Inflammatory and traction: mass lesion (tumour, edema, hematoma, haemorrhage), arteritis, phlebitis, neuralgia, occlusive vascular disease, temperomandibular joint syndrome
A=Atypical variants
M=Muscle contraction headache: depressive equivalents and conversion reactions, cervical osteoarthritis, chronic myositis
I=Infectious (meningitis, encephalitis)
N=Non-cranial sources (eyes, ears, nose, throat, teeth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of migraine headaches?

A 
"PUPIL"
P=Pulsatile quality
U=Unilateral location
P=Physical activity worsens headache
I=Inhibits daily activity when present
L=Location: temporal region of head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the precipitating factors for a migraine headache?

A 
C^6
Cino (wine)
Cheese
Chocolate
Citrus fruits
Coronary vasodilator (nitrates)
Contraceptive pill
17
Q

What are the side effects of tricyclic anti-depressants?

A

“A^4”
Anticholinergic side effects
Antihistaminic (sedation, weight gain)
Anti alpha-1 adrenergic (orthostatic hypotension)
Arrhythmogenic (quinidine-like ventricular cardiac effects)

18
Q

What are the signs and symptoms of depression?

A 
"ASSESS PAT"
Appetite diminished +/- weight loss
Sleep disturbance (especially diminished number of sleep hours)
Sexual libido diminished
Energy diminished
Suicidality
Self-worthlessness, guilt
Psychomotor agitation
Anhedonia
Thought process impaired
19
Q

What receptors do tricyclic antidepressants antagonise?

A 
"SHAM"
S=Serotonin
H=Histamine
A=Alpha
M=Muscarinic
20
Q

What are some anticholinergic side effects?

A 
"can't see, can't pee, can't spit, can't shit"
Can't see - blurred vision
Can't pee - urinary retention
Can't spit- dry mouth 
Can't shit - constipation
21
Q

What are the symptoms of generalized anxiety disorder?

A 
"STOMACH"
S=Scanning and vigilance
T=Two or more worries
O=Organic causes should be ruled out
M=Motor tension
A=Anxiety unrelated
C=Course of mood or psychotic should be ruled out
H=Hyperactive autonomics
22
Q

What drugs may cause depression?

A 
"PROMS"
P=Propanolol
R=Reserpine
O=Oral contraceptives
M=Methyldopa
S=Steroids
23
Q

What are some medications used for migraine prophylaxis?

A 
"Very Valuable Prophylactic Agents"
V=Verapamil
V=Valproate
P=Propanolol
A=Amitryptiline Hcl
24
Q

What questions should you ask the patient for insomnia?

A 
"INSOMNIA STRIKES HIM"
I=Interruption of sleep during night
N=Naps during the day
S=Snoring during the night
O=On the clock (What time do you go to bed? Total sleep time?)
M=Morning awakening
N=Narcolepsy (sudden fall asleep)
I=Illness/stress recently
A=Activity before going to sleep? (Watching TV)
S=Sadness
T=Tremor
I=Irritability
K=K-caffeine
E=Exercise (in the morning or afternoon)
S=Sweating/skin or hair changes, neck pain
HI=Heat/cold intolerance
M=Menstrual irregularities
25
Q

Key questions for migraine

A

"”WWHAM”
Who is it for?
Have they had it before – if not already diagnosed=refer
What are the Symptoms?
Severity of pain, visual disturbances, rash, stiff neck, vomiting
How long have they had it?
Frequent attacks, more than 2 attacks in a month = refer
Action taken?
OTC treatment failure, more than 3 days of codeine already taken = refer
Medication?
Hormonal therapy, analgesia overuse, vasoconstrictors

26
Q

Sumatriptan

A

ABCD of Sumatriptan
A - Acute migraine treatment / Asthenia as a side effect
B - Basoconstriction (“v”) of cerebral vessels
C - Coronary vasospasm
D - 5 HT1 type D receptor

27
Q

Prophylaxis and treatment of different headache types

A

Prophylaxis and treatment of different headache types mnemonic: “1st letters in name – prophylaxis last letters in name – treatment” Tension headache T-Tricyclic antidepressants (prophylaxis) N-Nsaids (treatment) Cluster C-Calcium channel blockers, corticosteroids L-Lithium with calcium channel blockers are prophylaxis Ter-Triptans - Treatment

28
Q

Clinical uses for gabapentin

A

Gabapentin
Gaba-gaba analogue
P-peripheral neuropathy, migraine, bipolar disorder, it is a calcium channel blocker

29
Q

What are the 54321 rule for migraine from the international headache society?

A

“54321”
5-5 or more attacks
4-repeated episodes lasting 4-72 hours untreated
2-Any two of the following unilateral, throbbing, worsened by movement and moderate to severe
1 Any 1 of the following nausea/vomiting, photophobia and phonophobia

30
Q

“SNOOP”

A 
"SNOOP"
S-Systemic signs or symptoms
N-Neurologic symptoms 
O-Onset>50 y/o
O-Onset was sudden
P-Papilledema, positional provocation, precipitated by valsalva, progressive headache or precipitated by change
31
Q

SIde effects of triptans

A

“Flashing tinkling neck ties”
Flashing-flushing
tinkling-tingling
neck ties-neck tightness

32
Q

Symptoms of horner’s syndrome found in cluster headaches

A 
"HORNs of the PAMpas deer"
HORN-Horner's syndrome
P-Ptosis
A-Anhidrosis
M-Miosis
33
Q

Critera for cluster headaches

A

Atleast 5 attacks fulfilling the critera
Severe or very severe unilateral, supraorbital and/or temporal lasting 15 to 180 minutes if untreated.
Headache is accompanied by greater than or equal to 1 of the following:
Ipsilateral conjunctival injection and/or lacrimation
Ipsilateral nasal congestion and/or rhinorrhoea
Ipsilateral eyelid edema
Ipsilateral forehead and facial sweating
Ipsilateral miosis and/or ptosis
A sense of restlessness or agitation
Attacks have a frequency from 1 or 2/day to 8/day

34
Q

Criteria for trigeminal neuralgia

A

Paraoxysmal attacks of pain lasting from a fraction of 1 seconds to 2 minutes, affecting one or more divisions of the trigeminal nerve.
Pain has greater than or equal to one of the following characteristics:
Intense, sharp, surficial or stabbing
Precipitated from trigger areas or by trigger factors
Attacks are stereotyped in the individual patient
There is no clinically evident neurological deficit
Not attributed to another disorder

35
Q

Side effects of sodium valproate

A 
"VALPROATE"
V-Vomiting
A-Alopecia
L-Liver toxciity
P-Pancreatitis and pancytopenia 
R-Retention of fat (weight gain)
O-Oedema (peripheral oedema)
A-Appetite increase
T-Tremor 
E-Enzyme inducer (liver)
36
Q

What are the trigeminal autonomic cephalalgias?

A

SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing)
SUNA (short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms)
Paroxysmal hemicrania
Cluster headache
Hemicrania continua

RTS (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions