Final Exam -- Headaches--Part II Flashcards Preview

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Flashcards in Final Exam -- Headaches--Part II Deck (37):
1

True or false: tension-type headaches are the most common type of headache worldwide.

True.

2

Tension-type headaches are ___________ (bilateral/unilateral) and ___________ (throbbing/non-throbbing).

Bilateral*, non-throbbing

3

Comparing tension headaches to migraines, which does worsen with exercise?

Migraine

4

Comparing tension headaches to migraines, which does not worsen with exercise?

Tension

5

Comparing tension headaches to migraines, which is not typically associated with nausea or vomiting?

Tension

6

Comparing tension headaches to migraines, which is typically associated with nausea or vomiting?

Migraine

7

In order to diagnose a tension headache, there must be at least 10 episodes of headaches fulfilling four other criteria. One of those four criteria is that the headache must last how long?

30 minutes to seven days

8

In order to diagnose a tension headache, there must be at least 10 episodes of headaches fulfilling four other criteria. One of those four criteria is there must be at least two of which four characteristics?

Bilateral*
Pressing/tightning* (nonpulsating)
Mild/moderate intensity*
Not aggravated by routine physical activity*

9

In order to diagnose a tension headache, there must be at least 10 episodes of headaches fulfilling four other criteria. One of those four criteria is there must be no nausea or vomiting* AND no more than one of photophobia or phonophobia*.

Free card.

10

In order to diagnose a tension headache, there must be at least 10 episodes of headaches fulfilling four other criteria. The last of those four criteria is that the headache is not better accounted for by another diagnosis.

Free card.

11

What is the most common trigger for a tension headache?

Stress*

12

Tension headaches are divided into infrequent/episodic, frequent, and chronic. On average, how often do infrequent/episodic headaches occur?

Less than 1 day per month on average

13

Tension headaches are divided into infrequent/episodic, frequent, and chronic. On average, how often do frequent headaches occur?

Between 1-14 days per month on average

14

Tension headaches are divided into infrequent/episodic, frequent, and chronic. On average, how often do chronic headaches occur?

More than 15 days per month on average

15

Tension headaches are divided into infrequent/episodic, frequent, and chronic. Which is most common?

Infrequent/episodic*

16

Treatment for tension headaches can include analgesics (ibuprofen, naproxen, aspirin) and acetaminophen. Which of these (analgesics vs acetaminophen) is less effective and should be limited in use to 9 days/month and limited to 2 doses/day?

Acetaminophen

17

Treatment for tension headaches can include analgesics (ibuprofen, naproxen, aspirin) and acetaminophen. Which of these (analgesics vs acetaminophen) is more effective and should be limited to 15 days/month?

Analgesics

18

Prophylaxis of tension headaches is done through stress avoidance. Use of which antidepressant can also be considered?

Amitriptyline*

19

Chronic daily headaches (aka "chronic migraines") are characterized by headaches occurring at least _____ days per month for at least _______ months.

At least 15 days/month for at least 3 months*

20

Which migraine subtype involves the brainstem or bilateral occipital hemispheres?

Migraine with brainstem aura (aka basilar migraine)

21

Basilar migraines need two or more of what symptoms for diagnosis? (FYI: these symptoms last 5-60 minutes)

Dysarthria
Vertigo/difficulty walking
Tinnitus and/or hearing impairment
Diplopia
Bilateral visual symptoms*
Bilateral paresthesia
Decreased consciousness

22

True or false: when asked to localize the pain, a patient with a basilar migraine will point to their entire forehead, just above the eyes.

False; they will more likely point to the back of their head (occipital area).

23

True or false: with basilar migraine, it is possible for a patient to have weakness

False; there should be no evidence of weakness.

24

Typically avoid beta blockers and triptans in basilar, hemiplegic, and retinal migraines.

Free card.

25

What type of migraine subtype is associated with unilateral weakness during the headache?

Hemiplegic migraine

26

True or false: the unilateral weakness of hemiplegic migraines can switch sides during an attack.

True.

27

The motor aura that occurs in hemiplegic migraines contrasts with the aura of basilar migraines in that the hemiplegic migraine auras last how long?

1 to 24 hours

28

Retinal migraine (aka ocular or ophthalmic migraine*) is thought to involve which arteries?

Central retinal and ophthalmic

29

What visual symptom occurs with a retinal migraine, and how long does it typically last?

Monocular scotoma or blindness*
Lasts from minutes to less than an hour

30

True or false: a retinal migraine is associated with a severe headache and can lead to permanent vision loss.

False; it can indeed lead to permanent vision loss, but the associated headache is mild*

31

Recurrent painful ophthalmoplegic neuropathy is characterized by paralysis of the ocular cranial nerves and ipsilateral headache*. Which cranial nerve is most often affected?

CN III*

32

The headaches that occur in recurrent painful ophthalmoplegic neuropathy can develop up to how many weeks prior to the eye muscle weakness? Does the eye muscle weakness ever resolve?

2 weeks; the muscle weakness does recover completely between attacks.

33

Trigeminal neuralgia involves extreme pain. Does it occur bilaterally or unilaterally?

Unilaterally*

34

True or false: hypotension is a risk factor for trigeminal neuralgia.

False; hypertension is a risk factor for trigeminal neuralgia. (Thought to be due to compression on the nerve by an artery or a vein.)

35

Trigeminal neuralgia episodes last how long? Which branches of the trigeminal nerve are most commonly affected?

Episodes last a few seconds to 2 minutes*
V2 and/or V3 are most commonly affected*

36

What drug can be used to treat trigeminal neuralgia?

Carbamazepine*

37

What surgical options are available for trigeminal neuralgia?

Microvascular decompression (move the artery or vein away from the nerve), or lesion the trigeminal nerve.