Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
what are the two most common types of primary headaches? |
tension and migraine |
|
|
what are some common causes of secondary headaches? |
URTI sinusitis TMJ dysfunction cervical spine issue withdrawal (opiates, nicotine, caffeine) |
|
|
what is generally thought o be the cause of headaches? |
neurogenic inflammation due to the release of neuropeptides from the trigeminal nerve endings that encapsulate the blood vessels of the pia, duramater |
|
|
how would you treat a migraine? |
- get away from things that ppt it (foods, stress, lights, loud noises, loss of sleep) - take a mild analgesic - ergotamines with caffeine - triptans (high affinity for 5-HT receptor) - prophylactic therapy is available (BBs, antidepressants, anti convulsants) |
|
|
how would you treat a tension type (most common) of headache? |
simple analgesics, rest, and reduction in alcohol consuption is usually enough. Some may require TCAs |
|
|
mass lesions can present in a variety of ways but what are some things you really should look for? |
- new onset in middle aged - focal or diffuse neurological dysfunction - raised ICP - often present in the mornign |
|
|
what are some Differential for morning headaches? |
OSA hypglycaemia mass lesion too much or too little sleep chronic pain depression |
|
|
idopathic intracranial htn, who is likely to get it and how do you treat it? |
middle aged obese women - weight loss - CA inhibitors - diuretics - surgery to shunt CSF |
|
|
trigeminal neuralgia in a young patient, what must be investigated? |
MS - treat TGN with benzos - EtOH injection to infected nerve may also help - surgical decompression if impingment |
|
|
why does PMR and GCA often coexist? |
both prefer similar HLA haplotypes both affect similar populations (>50) both show similar patterns of cytokines PMR effects the girdles and gives flu-like symptoms (like GCCA) but GCA can cause blindness giant cells, intimal fibrosis |
|
|
Volume of Distribution = Dose / Concentration (ng/L) |
|
|
|
what factors would lead to poor bioavailability of a drug? |
poor absorption instability degradation metabolism (liver, kidneys, other) |
|
|
what do we mean when we say that diabetes is a small fiber neuropathy? |
pain and T sensation are affected but we preserve vibration, proprioception and deep tendon reflexes |
|
|
what is the difference between cauda equina syndrom and spinal cord compression when presenting? |
i think compressions will be more dermatomal but can have hyperreflexia and upgoing plantars, while CAS will present below L2 and cause a saddle parasthesia |
|
|
define: parasthesia dysaesthesia hyperpathia |
- an abnormal sensation (tickling or prickling) when pressure is applied - an abnormal, unpleasant feeling when touched, caused by damage to peripheral nerves - an elevated pain response to a NOXIOUS stimuli (allodynia is not noxious) |
|
|
how would a patient with spinal stenosis present? |
older age bracket wide based gait pain is relieved when bending forward "pseudoclaudication" neurognic claudication |
|
|
what is the role of aldose reductase and neuropathy? |
in diabetics, too much sugar triggers this enzyme to reduce glucose to the neurotoxic sorbital and fructose aldose reductase inhibitors can be used |
|
|
what is the first line of treatment for neuropathic pain? |
pregabalin TCAs can be used as well |
|
|
what would happen if you went cold turkey with morphine? |
flu-like symptoms - abdo cramps and diarrhea - dysphoria - hyperalgesia |
|
|
which morphine derivatives have mew selectivity? |
heroine (enters brain rapidly) codeine (antitussive) oxycodon (acute pain with peripheral analgesic) |
|
|
define somatization |
the manifestation of psychological distress in the presentation of bodily symptoms |
