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15 Cards in this Set
- Front
- Back
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What are some life history things associated with recurrent headaches (migraines)?
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car sickness, night terrors, episodic nausea or abdominal pain as child.
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What are medical considerations and co-mobidities of headaches?
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COPD, thyroid dx**, hypertension, anemia, IBS, abuse, depression, anxiety, bipolar
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What are clues that could lead one to suspect a secondary disorder w/ onset of headache?
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pt. stating that it's "worst headache of my life," abnormal neuro finding, HA onset at older age, new headaches in someone w/ HIV or cancer history
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What tests should be considered if you suspect a secondary disorder and wha might you be looking for in each?
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Erythrocyte sedimentation Rate: sensitive test for temporal arteritis; brain CT or MR looking at blood and soft tissues; Lumbar puncture looking at opening pressure: red cells= subarach hem, white cells= infxn
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What are parts of the brain both intracranially and extracranially that are sensitive to pain?
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Intra- cranial sinuses and afferent veins, arteries and veins of dura matter, arteries of the base of the brain and their major branches, parts of dura matter around large vessels. Extra: skin, scalp, fascia, muscles, mucosa, arteries
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What nerves supply pain in the head and where to they supply?
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Trigeminal nerve serves face and meninges. CN VII, IX, and C2,3 serve the back of the head
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What is the criteria to diagnose migraine?
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1: at least5 attacks lasting 4-72 hrs, 2: at least 2 of following: unilat head pain, throbbing or pulsating, mod to severe pain affecting funxning, worsening of pain w/ routine activity. 3: N or V, sensitivity to light and sound.
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What are some common auras of migraines?
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visual disturbances such as wavy vision, scotomas, bright light flashes, Alice in Wonderland experience; Aphasia, Vertigo, Numbness around mouth and hands, Diplopia
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What are some common findings w/ cluster headaches? When is it most common? What is the pathophysiology?
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orbital, supraorbital, or temporal pain lasting 15-180 min. Assoc. w/ conjunctival injxn, lacrimatn, nasal congsn, rhinorrhea, forhead and facial sweating, Horner's syn, ptosis, eyelid edema. Occurs more in men and is clustered in Spring and Fall Hypothalamus caused parasym stimulation (lacrimating, nasal congsn) and symp stim (Horners)
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What is temporal arteritis, what age group does it affect, What are its assoc. symptoms, how dx, and what is tx?
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Inflammatory condition of cranial arteries w/ bitemporal heachche. Usually occurs in elderly. Assoc. w/ rheumatica, jaw claudication**, wt loss, anemia, polyarthraglia and can cause blindness due to cilioretinal artery occlusion
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What signs are assoc. w/ brain tumors or intracranial hypertension?
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wakening at night by headache, projectile vomiting, papilledema. Idiopathic intracranial hypertension assoc. w/ obese women of child bearing age show incr pressure on LP
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What signs are assoc. w/ low-pressure headaches and how might it be diagnosed?
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worse on upright position. Caused often by LP. May show meningeal enhancement w/ low lying cerebellar tonsils.
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How might one diagnose meningitis?
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Fever and headache. LP shows incr WBC and protien in CSF
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What are some findings in trigeminal neuralgia?
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Lancinating volleys of pain along the distribution of 5th nerve. Triggered by brushing teeth or light touch. In young people it is associated w/ demylination and in older folks: vascular loop on nerve root entry zone
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If a patient comes w/ a rash on their forhead and complaining of a headache, what might you suspect? What is a major risk in this situation?
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Could be Herpes Zoster Tip of nose could be involved as well as eye- complications
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