SGL 3- Headache Quiz Flashcards
Which of the following headache types is the most prevalent?
Tension-type headache
Which of the following is characterized by pronounced parasympathetic signs including lacrimation and drooping of the face?
trigeminal autonomic cephalgia
What is the most immediate concern when a patient presents with a secondary headache?
identification of the causative agent
Which cranial nerve conveys orbitofrontal headache pain?
CN V
Which type of headache may be preceded by somatosensory or visual symptoms?
migraine with aura
What is diplopia? What is amaurosis fugax?
Diplopia, otherwise known as double vision, is when a person sees two separate images of a single object.
Amaurosis fugax is a temporary loss of vision in one or both eyes due to lack of blood flow to the retina.
What does 20/300 mean compared to 20/30?
A visual acuity of 20/300 means that at 20 feet you can see what a normal person (20/20) sees at 300 feet and a visual acuity of 20/30 means that at 20 feet you can see what a normal person sees at 30 feet.
A visual acuity of 20/300 means that you have really poor vision compared to a visual acuity of 20/30.
What is jaw claudication? What are some common causes of jaw claudication? How could jaw claudication be associated with amaurosis fugax?
Jaw claudication- Pain in the jaw associated with chewing.
Claudication of jaw is a specific symptom of giant cell arteritis. Giant cell arteritis is an inflammation of the lining of your arteries.
Commonly, amaurosis fugax caused by giant cell arteritis.
What is the significance of the ESR and CRP levels?
Both tests are used as markers of inflammation.
ESR is a blood test that measures how quickly red blood cells settle at the bottom of a test tube that contains a blood sample.
- faster than normal settling may indicate inflammation
C-reactive protein is a substance produced by the liver in response to inflammation.
-A high level of CRP in the blood is a marker of inflammation.
FEVER is a symptom of inflammation.
ESR of 70 and a level of 59 for CRP are elevated.
How is giant cell arteritis confirmed through biopsy?
The best way to confirm a diagnosis of giant cell arteritis is by taking a small sample (biopsy) of the temporal artery. This artery is situated close to the skin just in front of your ears and continues up to your scalp. The procedure is performed on an outpatient basis using local anesthesia, usually with little discomfort or scarring. The sample is examined under a microscope in a laboratory.
What is giant cell arteritis (GVA)?
-most common form of vasculitis
- cause of GCA is uncertain but it is believed to be an autoimmune disease in which the body’s own immune system attacks the blood vessels, including the temporal arteries
- more common in adults over 50 years of age
- women are 2-3 more times likely
- Family history of the disease
- Polymyalgia rheumatica (inflammatory disorder that causes muscle pain)- increased risk for developing GCA
Long term use of glucocorticoids is called?
Cushing syndrome- spindly legs, big abdomen.
What are glucocorticoids?
Glucocorticoids (Steroids) are currently the standard treatment for GVA
- anti-inflammatory
- alleviates pain
- increases metabolism of glucose
- side effect is the transformation of protein to glucose
- based on the premise of immediately suppressing the vascular inflammation to decrease the risk of blindness
What kind of drug is Actemra and how does it work to ameliorate GVA?
Actemra, also known as Tocilizumab is in a class of drugs called biologics and is an interleukin 6 (IL-6) monoclonal antibody.
IL-6 is a pro-inflammatory cytokine which is
produced by immune cells such as T and B cells, lymphocytes, and monocytes. This drug is typically given when TNF inhibitors are ineffective and is expected to be taken in combination with steroid tapering.
What is paroxysmal hemicrania?
Paroxysmal hemicrania is a rare form of headache that usually begins in adulthood. Patients experience severe throbbing, claw-like, or boring pain usually on one side of the face; in, around, or behind the eye; and occasionally reaching to the back of the neck.
-is a cluster headache AKA trigeminal autonomic cephalgia
