Lecture 2 - Headache Flashcards Preview

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Flashcards in Lecture 2 - Headache Deck (20)
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1
Q

Migraine:
unilateral or bilateral?
clasically described as ____ pain with nausea, ____phobia, and ____phobia;
symptoms ____ with physical activity

A

unilateral;
pulsating/throbbing;
phono, photo;
worsen

2
Q

migraines:
last between ___ and ___ hours;
some patients may experience an ____ with neurologic symptoms such as ____ (visual) or ____ in patients with a familial channelopathy

A

4, 72;
aura;
scotomas;
hemiplegia (ie paralyzed goats)

3
Q

migraines:
CN _____;
gut motility is ____

A

hyperexcitability;

slowed

4
Q

migraine:

due to irritation of CN ___, ____, or _____

A

5 (Trigeminal), meninges, blood vessel

5
Q

migraine:

blood vessels release _____, _____, and vasoactive peptides –> vaso____ and protein extravasation –> neurogenic ______

A

substance P, calcitonin-gene releated peptide (CGRP), vasodilation;
inflammation

6
Q

migraine:
____ are released and facilitate production of prostaglandins. these sensitize meningeal ___ receptors –> decreased threshold

what Cranial nerve nucleus is important?

A

kinins;
pain;

trigeminal nucleus caudalis (TNC)

7
Q

migraine central sensitization:
____ neurons are activated early, this is the ___ pain phase;
____ neurons are activated later. this is the ____ pain phase

A

peripheral, mild;

central, migraine (ie v bad)

8
Q

acute treatment:
triptans, which are selective ____ agonists;
also _____

A

5HT1b and 5HT1d;

dihydroergotamine

9
Q

migraine prophylaxis:
2 anti-epileptics?
beta-blocker =
TCA =

A

valproate, topiramate;
propanolol;
amitryptiline

10
Q

childhood precursors to migraine:
cyclic ____;
____ pain;
benign paroxysmal vertigo

A

vomiting;

abdominal

11
Q
tension headaches:
unilateral or bilateral?
constant or pulsatile?
must last more than \_\_\_\_;
precipitated by physical activity or aura?
\_\_\_ tenderness
A
bilateral;
constant steady pain;
30 minutes;
nope;
pericranial
12
Q
cluster headache:
unilateral or bilateral?
constant or episodic?
how long do they last?
often precipitated by \_\_\_\_
A

unilateral;
episodic/repetitive;
15 min - 3 hours ie short;
alcohol use

also called “Trigeminal autonomic cephalgia”p

13
Q

cluster headache:
pain is ____;
localized in ____ or temporal regions;
autonomic symptoms such as ____, ____, conjunctival injection, ____ syndrome

A

excruciating;
peri-orbital;
rhinorrhea, lacrimation;
horner

14
Q

cluster headaches: treat with _____ and _____

A

sumatriptan + 100% O2

15
Q

post concussive headaches:
follows ____ trauma.
symptoms include headache with ____, ____ vision, insomnia, dizziness, trouble concentrating etc;

A

minor (ie car accident);

vertigo, blurred

16
Q
temporal arteritis:
classically affects who?
unilateral or bilateral headache?
jaw \_\_\_\_;
treat with \_\_\_\_
A

elderly females;
unilateral (follows temporal);
claudication;
high dose corticosteroids

17
Q

another name for idiopathic intracranial hypertension?

classically seen in who?

A
pseudotumor cerebri;
obese woman (or pregnant)
18
Q

pseudotumor cerebri:
drugs that can cause it include _____ (antibiotic), _____, _____ excess;

treat with weight loss, ____ ( a diuretic), serial _____

A

tetracycline, danazol, Vitamin A;
acetazolamide (or furosemide), LPs

also steroids, optic nerve fenestration

19
Q

post lumbar puncture headaches:

pain when _____ that resolves when ____;

A

standing;

lying flat

20
Q
medication overuse headache:
headaches are worse in the \_\_\_\_;
headaches resolve after what?
thought to involve \_\_\_\_ receptors;
classic cause
A

morning;
termination of subtance (Greater than 2 months);
serotonin;
caffeine (can confirm)