Bell's Palsy etc & HA Flashcards

(45 cards)

1
Q

tx Bell’s Palsy? (3)

A

Prednisone 60 mg taper x 10 days
Valacyclovir 1 g TID x 7 days
artificial tears/eye lubei

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2
Q

indications for labs/imaging in Bell’s Palsy (2)

A

fasting blood sugar in DM

MRI if bilateral or no forehead involvement

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3
Q

nerve branches more commonly affected by trigeminal neuralgia?

A

V2 and V3

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4
Q

Bell’s palsy is more common on which side

A

right

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5
Q

tx trigeminal neuralgia (4)

A

Carbemazepine starting 100-200 BID —> 600-1200 mg/day
Anticonvulsants: Lamotrigine, gabapentin, phenytoin
peripheral nerve block
surgical intervention for refractory pain

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6
Q

carbamazepine tx special characteristic?

A

regular CBCs

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7
Q

jaw claudication

A

temporal arteritis

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8
Q

diagnostic criteria for temporal arteritis

A
3/5:
age at onset > 50
new localized HA
temporal a. tenderness and decr. temporal pulse
ESR> 55
positive temporal a. biopsy
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9
Q

classic lab finding of temporal arteritis

A

elevated ESR

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10
Q

biopsy for temporal arteritis? (2)

A

multinucleate giant cells

need > 2 cm of artery due to skip lesions

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11
Q

tx temporal arteritis (2)

A

Prednisone

monitor ESR

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12
Q

unilateral weakness/paralysis, numbness, eye irritation, onset w/in 3 days
involves the forehead

A

Bell’s Palsy

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13
Q

periauricular pain & tenderness, crepitus w/ jaw mvmt

A

TMJ dysfunction

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14
Q

more frequent form of migraine?

A

migraine w/o aura (“common”)

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15
Q

throbbing, pulsatile unilateral pain. 4-72h

N/V, confusion, blurred vision, mood changes, sensitivity to light & sound

A

migraine w/o aura

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16
Q

visual, verbal, or sensory sx 10-60 min prior to HA

usually unilateral. N/V, photophobia, etc

A

migraine w/ aura

“classic”

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17
Q

indications for imaging w/ HA (5)

A
changes in HA
new neuro sx
refractory
new onset after 50
HIV or CA pts
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18
Q

chest pressure/heaviness, flushing, weakness, drowsiness, dizziness, malaise, warmth, paresthesias

A

triptan sensation- a side effect

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19
Q

triptan contraindications (5)

A
uncontrolled HTN
hx MI
CVD
PVD
pregnancy
20
Q

preventative migraine mgmt prescriptions (3)

A

B-blockers: Propranolol

antidepressants: TCAs, SSRIs
anticonvulsants: Topiramate

21
Q

most common type of HA?

22
Q

infrequent tension type HA classification?

23
Q

frequent tension HA classification

A

10-14 days/mo

lasting 30 min to several days

24
Q

chronic tension HA classification

A

> 15 days/mo

lasts hours to days

25
tension HA triggers (5)
``` stress/lack of sleep jaw clenching missed meals depression head/neck strain ```
26
sharp, boring, unilateral, periorbital HA w/ autonomic sx | attacks last 15-180 min
cluster HAs
27
cluster HA disease course (4 types)
attacks: every other day, 8x day clusters: 6-12 weeks remission: up to 12+ months chronic: clusters lasting > 1 years or remission
28
restless pt, sitting, rocking. Conjunctival injection, lacrimation, eyelid edema, nasal congestion, ptosis, miosis, sweating
cluster HA
29
triggers for cluster HA
alcohol smoking stress
30
cluster HA imaging indication
always initially- these things are crazy! | MRI or CT
31
cluster HA tx (3)
O2, nonrebreather for 15 min subQ sumatriptan Verapamil as preventative
32
moderate pain on sides or top of head | > 15 days/mo during 3+ months
chronic daily HA
33
continuous, fluctuating pain or same side of face/head lasting minutes to days may have tearing, irritated eyes, rhinorrhea
hemicrania continua
34
tx hemicrana continua (2)
indomethacin | &/or corticosteroids
35
mild-severe pain, throbbing/tightening bilaterally. light/sound sensitivity may be following infection, meds, trauma, other condition
newly daily persistent HA
36
tx newly daily persistent HA (3)
muscle relaxants antidepressants anticonvulsants
37
primary stabbing HA tx (3)
indomethacin abortive drugs trigger avoidance
38
primary exertional HA workup
MRI/MRA to r/o vascular abn
39
> 50 y/o, develops during sleep and wakes people up | mild-moderate throbbing, both sides of the head
hypnic HA
40
hypnic HA disease course
> 10 episodes/month | lasting 15 min- 3 h
41
hypnic HA workup & treatments (3)
MRI: new presentation over age 50, waking up at night caffeine at night indomethacin lithium
42
indications for CT/MRI, ~ LP (5) with secondary HA
``` Systemic symptoms or illness (HIV, CA, infection, sinusitis) Neurological hx Onset sudden Older (> 50 y/o) Previous hx (1st HA or change) ```
43
sx increase w/ cough, exertion, straining, position change | Papilledema, vision loss, pulsatile tinnitus
idiopathic intracranial HTN
44
unilateral HA that's not a migraine, secondary can be
CVA
45
delayed onset of dizziness, tinnitus, N/V, visual changes | hx trauma
post concussion syndrome