Unit 1: Headaches

Question 1

What type of spontaneous non-traumatic headache has the following symptoms: nuchal rigidity, vomiting and is said to be “worse ever”?

Answer 1

Subarachnoid

Question 2

a. What is the triad for meningitis?

b. What other symptom can be observed with this type of headache?

Answer 2

a. Nuchal rigidity, sudden high fever and altered mental status
b. vomiting

Question 3

Lumbar puncture aka is

Answer 3

Low-pressure Headache

Question 4

What type of HA has CSF leakage from site of injury and described as a feeling of Dull/Throbbing.

Answer 4

Lumbar Puncture AKA Low-Pressure headache

Question 5

What headache is associated with Kernig sign/Brudzinski’s sign and is fatal if untreated?

Answer 5

Meningitis

Question 6

Berry aneurisms (congenital), anterior-vensous rupture and loss of pupillary light reflect are associated w/what type of HA?

Answer 6

Subarachnoid

Question 7

What are the symptoms observed in Giant Cell Arteritis?

Answer 7

unilateral temporal pain
visual disturbances
diplopia insidious onset

Question 8

What HA is associated with polymyalagia rheumatic (all joints hurt), kit provoked by anything touching the Temporal artery?

Answer 8

Giant cell arteritis

Question 9

a. Name the condition would you expect to see elevated ESR, ALP and CRP on lab work?
b. What is the gold standard for this DX?

Answer 9

a. Giant cell arteritis

b. Biopsy; Halo sign on ultrasound

Question 10

What headache has generalized pain that occurs every few days and is worse in the a.m?

Answer 10

Hypertension HA

Question 11

What HA is 90% genetic, made worse with estrogen in females and has subtle changes?

Answer 11

Migraine

Question 12

Classic migraine must have what lasting up to 60 mins?

Answer 12

it must have a Reversible aura

Question 13

What is the triad symptoms for a classic migraine?

Answer 13

Aura, photophobia and nausea

Question 14

What is the difference between a classic migraine and a common migraine?

Answer 14

Common migraines do NOT have an aura and is provoked by stress/alcohol and last up to 3 days.

Question 15

Rebound HA are also known as

Answer 15

Medication overuse HA

Question 16

A pt frequently taking meds or drinking caffeine may experience anxiety, memory problems and irritability from what type of HA?

Answer 16

Medication overuse HA (MOH) aka Rebound HA

Question 17

This HA has a male predilection (pt in his 20s) and occurs same time of day/night.

Answer 17

Cluster HA

Question 18

What HA is episodic lasting weeks to months w/remissions months to years? Pt might say it feels deep, constant, piercing around one eye.

Answer 18

cluster HA

Question 19

Horner’s Syndrome is a rare condition. a. What is it characterized by? b. What can be observed?

Answer 19

a. miosis (constriction of the pupil),

b. ptosis (drooping of the upper eyelid), and anhidrosis (absence of sweating of the face).

Question 20

a. Which HA is worse at the end of the day?

b. What regions of the brain does this condition effect?

Answer 20

a. Tension HA

b. effects Frontal/Temporal. it can also cause tachycardia

Question 21

Tension headaches have what type of treatment?

Answer 21

over the counter meds and ADJ’s

Question 22

What HA has its source of pain on one side of the neck and effects the occulofrontal region of the brain?

Answer 22

Cervicogenic HA

Question 23

Which HA is associated with CN XI, C1-4 (MC C2).

Answer 23

Cervicogenic HA

Question 24

Cervicogenic HA must have to be diagnosed?

Answer 24

Postural distortions

Question 25

What headache is provoked by bending down and can have pain in the low back?

Answer 25

Dehydration HA

Question 26

Which HA generally viral lasting less than 10 days but can be bacterial if it last longer than 10 days?

Answer 26

Sinusitis. symptoms are facial pain over sinuses

Question 27

Sinusitis HA MC effects what sinus?

Answer 27

maxillary

Question 28

What is known as the suicide disease or tic douloureux during these sever attacks?

Answer 28

Trigeminal neuralgia

Question 29

What is the cornerstone diagnostic testing of meningitis?

Answer 29

CSF/Lumbar puncture

Question 30

Spinal cord tumors are best seen on

Answer 30

MRI

Question 31

Name the condition commonly associated with polymyalgia rheumatic.

Answer 31

Giant cell (Temporal) arteritis

Question 32

Name the risk for a lumbar puncture

Answer 32

headache infection lumbar nerve damage bleeding into spinal cord

Question 33

An acute onset of a headache has what time and intensity?

Answer 33

Acute Time: onset w/I 2-3 dys max Intensity: severe

Question 34

A subacute onset of a headache has what time and intensity?

Answer 34

Subacute Time: onset wks-months, may be acute presentation Intensity: Not as severe

Question 35

A chronic onset of a headache has what time and intensity?

Answer 35

Chronic/Recurrent Time: onset usually years Intensity: varied

Question 36

According to lecture material, most HA's are the result of

Answer 36

vaso-dilation and vaso-constrictive events

Question 37

What are the 4 categories or causes of HA?

Answer 37

neuromuscular events tension/cervical spine dz metabolic miscellaneous

Question 38

HA's can be characterized or described as

Answer 38

pulsating, tightness, dull and steady, sharp/lancinating (cutting, piercing, or stabbing), ice pick

Question 39

What are some associated symptoms for HA?

Answer 39

weight loss, fever/chills, dyspnea, visual disturbances, nausea/vomiting, photophobia

Question 40

Physical exam for HA: Respiratory insufficiency can cause elevated what

Answer 40

intracranial pressure

Question 41

Tachycardia can occur with pt's experiencing

Answer 41

anxiety, tension, tension HA

Question 42

What conditions has the classic symptom of a "thunder clap", "like being kicked in the head" or the "worst ever" over the matter of secs to mins?

Answer 42

Subarachnoid hemorrhage

Question 43

Pulsating towards occiput, vomiting, confusion, orbital pain, visual loss/diplopia and seizures are symptoms seen with what dz?

Answer 43

Subacrachnoid hemorrhage

Question 44

What condition can occur d/t rupture of arterial venous malformation and damage to anterior or middle meningeal artery and what will be loss?

Answer 44

Subarachnoid hemorrhage and visual loss/diplopia

Question 45

Which is worse an arterial venous malformation HA or Berry aneurysm HA?

Answer 45

Berry aneurysm HA