Flashcards in 10 Kurtz Head Pain Emergent Deck (12)
What are the three things you would ask about to help you distinguish between emergency and non-emergency head pain?
- onset: how rapid?
- severity: how bad (7 is severe)
- frequency: have you had it before?
What are the two tentative diagnosis of emergencies presenting with periocular pain?
orbital cellulitis and giant cell arteritis (temporal arteritis)
List the tentative diagnosis of emergencies presenting with cranial pain.
- subarachnoid hemorrhage, SAH
- malignant hypertension
How would you test your CN 2, 3, 4, 6, and 8?
VA, VF, pupils, ptosis, and EOMs
You touch the patient's face with a tissue on mirror-image points within each of the 3 dermatomes. Which CN function are you testing for?
You instruct the patient to raise both eye brows, clamp eyes tightly shut, puff out both cheeks and alternately grimace and smile. What CN function are you testing?
You make a white noise by rubbing your fingers together and ask the patient (with one ear occluded) to tell you when he/she first hears the white noise. What CN function are you testing? And what is an alternative way to doing this test.
CN-8; vestibulocochlear nerve
Can have patient have both ears open and ask which noise is louder. Should be the same
You have the patient stick his/her tongue straight out and hold it. Which CN function are you testing?
You have the patient extend arms, palms up, eyes closed. What are you testing?
the Descending Pyramidal Motor System
List 3 non-specific signs of elevated ICP; intracranial pressure.
loss of spontaneous venous pulsation
sixth-nerve (CN-6, abducens) palsy
What are the 10 red flags of HA emergency?
1. first HA in pt > 50 yo
2. sudden onset (thunderclap)
3. (+) neuro si ≠ aura
4. stiff neck
5. unexplained fever
6. unexplained vomiting
7. marked change in pattern
8. recent malignancy, head trauma
9. worsening HA
10. BP 180/115