Headache Flashcards
(128 cards)
1
Q
What is another name for headaches?
A
Cephalgia
The term ‘cephalgia’ is derived from Greek roots meaning ‘head pain’.
2
Q
What are primary headaches?
A
Headaches with no known organic cause, including:
* Migraine
* Tension headache
* Cluster headache
“Just my head hurts”
Primary headaches are often considered ‘functional’ as they are not attributed to any underlying medical condition.
3
Q
What are secondary headaches?
A
Headaches that are a symptom related to a medical condition, such as:
* Brain tumor
* Aneurysm
* Sinus infection
* CVA (Cerebrovascular Accident)
* Neck injury
something else is causing pain
Secondary headaches are considered ‘organic’ and indicate an underlying health issue.
4
Q
True or False: Headaches can interfere with activities and lifestyle.
A
True
The discomfort caused by headaches can significantly impact daily functioning.
5
Q
Fill in the blank: Primary headaches are also known as _______.
A
Functional
This term reflects the lack of an identifiable organic cause.
6
Q
Fill in the blank: Secondary headaches are also known as _______.
A
Organic
This term indicates that they are caused by an underlying medical condition.
7
Q
What types of headaches fall under the category of primary headaches?
A
The types include:
* Migraine
* Tension headache
* Cluster headache
Each type has different characteristics and treatment options.
8
Q
What can cause secondary headaches?
A
Medical conditions such as:
* Brain tumor
* Aneurysm
* Sinus infection
* CVA
* Neck injury
Identifying the cause is essential for proper treatment.
9
Q
What is the significance of headaches in terms of physical complaints?
A
They are one of the most common physical complaints.
This prevalence highlights the importance of understanding headache types and treatments.
10
Q
What treatment modality may be beneficial to more than one headache type?
A
Botulinum toxin
11
Q
True or False: Botulinum toxin is effective only for migraine headaches.
A
False
- Botulinum toxin has been found to work on BOTH tension type and migraine headaches.
12
Q
Fill in the blank: _______ toxin has been found to work on both tension type and migraine headaches.
A
Botulinum
13
Q
What are some types of headaches that do NOT require medical attention?
A
- Hangovers
- Caffeine withdrawal
- Med withdrawal like fluoxetine (SSRI)
- Medication Overuse Headache (MOH)
These headaches are often manageable with home care and may not indicate a serious underlying condition.
14
Q
Headaches are the most common side effect associated with what medications?
A
Erectile dysfunction
This statistic highlights the prevalence of side effects in users of erectile dysfunction medications.
15
Q
True or False: All headaches require medical attention.
A
False
Many headaches can be treated at home and do not necessitate professional medical intervention.
16
Q
What type of headache involves pain in and around one eye?
A
Cluster headache
Cluster headaches are characterized by severe pain localized to one side of the head, often around the eye.
17
Q
What is the typical sensation described in a tension headache?
A
Pain like a band squeezing the head
Tension headaches are often described as a tightness or pressure around the head.
18
Q
What symptoms are commonly associated with a migraine?
A
Pain, nausea, and visual changes
Migraines can also include symptoms such as sensitivity to light and sound.
19
Q
Fill in the blank: The classification of headaches includes _______.
A
cluster, tension, and migraine
20
Q
What is the first step in the assessment of headache?
A
A detailed description of the headache is obtained
This includes specifics such as location, duration, and intensity.
21
Q
What should be included in the patient’s history during headache assessment?
List 4
A
Medication use & history, exposure to toxins, stress and coping, family history
These factors can influence headache occurrence and management.
22
Q
How do types of headaches manifest in different people?
A
Differently in different persons; symptoms in one individual may also change over time
This variability can complicate diagnosis and treatment.
23
Q
True or False: Most headaches indicate serious disease.
A
False
Although most headaches are benign, persistent headaches require investigation.
24
Q
What is a key reason to investigate persistent headaches?
A
They may indicate underlying serious conditions
Regular assessment is important for effective management.
25
What does the **choice of medication** depend on?
Type of headache
26
What is the primary goal of headache medication?
To reduce the frequency and severity or stop headache
27
True or False: It is safe to use vasoactive medications in **all** patients.
False
28
Caution is advised when using vasoactive medications in __ patients.
cardiac
29
What is a **cluster** headache?
A rare, **primary headache disorder** that consists of severe headaches on **one side** of the head.
## Footnote
Cluster headaches are characterized by their intensity and specific symptoms.
30
What are common symptoms associated with cluster headaches?
List 4
Symptoms include:
* Red or teary eyes: *hallmark symptom*
* Runny or stuffy nose
* Flushing or sweating of the face
* Sense of restlessness and agitation
## Footnote
These symptoms help differentiate cluster headaches from other types of headaches.
31
True or False: Cluster headaches occur on **both** sides of the head.
False
## Footnote
Cluster headaches typically affect only one side of the head.
32
**Where** is the pain typically located during a **cluster** headache?
Site: **Uni**lateral, radiating up or down from **one eye**
## Footnote
This unilateral nature distinguishes cluster headaches from other headache disorders.
33
What is the **quality of pain** experienced in cluster headaches?
Sharp, stabbing (excruciating)
## Footnote
This specific quality of pain is a key feature of cluster headaches.
34
How frequently do **cluster** headaches occur?
They may occur **1-8 times per day** over a period of 2 weeks to 3 months, with months or years between attacks.
## Footnote
The episodic nature of cluster headaches can lead to significant distress for sufferers.
35
True or False: Cluster headaches can occur **bilaterally**.
False
## Footnote
Cluster headaches are characterized by unilateral pain, typically affecting one side of the head.
36
Which **lifestyle factors** are associated with cluster headaches?
Smoking and alcohol ingestion
* These factors may trigger or exacerbate cluster headaches.
37
In which **population** are cluster headaches **more common**?
More common in **men** between ages 20-40
## Footnote
This demographic shows a higher incidence of cluster headaches compared to women.
38
What is the duration range of a cluster headache episode?
5 min - 3 hrs
## Footnote
Cluster headaches can vary significantly in duration from a few minutes to several hours.
39
What is the **symptomatic** treatment for **CLUSTER headaches**?
(Treating the symptom)
* Oxygen
* sumatriptan (Imitrex)- *triptan class*
* ergotamine tartrate (Cafergot, Ergomar)
## Footnote
Oxygen should be administered at 100% @ 6 to 8 liters per minute for 10 - 15 minutes.
40
What is the recommended **administration for oxygen** in **cluster** headache treatment?
100% @ 6 to 8 liters min for 10 - 15 minutes
## Footnote
This method helps alleviate symptoms during an attack.
41
Name a **medication** used for symptomatic relief of **cluster** headaches.
Sumatriptan (Imitrex)
## Footnote
Sumatriptan is a common triptan used to treat acute cluster headaches.
42
What is ergotamine tartrate used for?
Symptomatic treatment of cluster headaches
## Footnote
Available under the brand names Cafergot and Ergomar.
43
List 6 **prophylactic** medications for **cluster** headaches.
* α-Adrenergic blocker (**ergotamine**)
* Serotonin antagonist
* Corticosteroids
* Calcium channel blockers
* Lithium
* Biofeedback
These treatments aim to prevent the **occurrence** of cluster headaches.
44
True or False: **Corticosteroids** are used as a **prophylactic** treatment for **cluster** headaches.
True
## Footnote
Corticosteroids help reduce the frequency of cluster headache attacks.
45
What should **ergotamine** NOT be used with?
Serotonin receptor agonists (**triptans**)
## Footnote
Combining these medications may have additive effects and cause excessive vasoconstriction.
46
What are the additive **effects** of **combining** ergotamine with triptans?
Additive effects and **excessive** vasoconstriction
* Vasoconstriction increases BP
47
What is the **primary effect of vasoconstriction** in relation to **cluster** headaches?
**Vasoconstriction** has been shown to **minimize** the headache.
48
What is the **typical result of the neurological exam** in **tension** headache diagnostics?
Often negative (nothing abnormal)
* dont often cause neurological deficits.
49
What should be inspected during the **tension headache** diagnostics?
Local infections
50
Q: Why is palpation important in diagnosing a tension headache?
A: To check for muscle tenderness or trigger points in the scalp, neck, and shoulders.
51
Q: Why is **auscultation for bruits** over the arteries done during a **headache exam?**
A: To listen for abnormal blood flow sounds, which could indicate vascular cause for the headache such as carotid artery stenosis.
52
Which **laboratory tests** are commonly included in the diagnostics for tension headaches?
(List at least 4)
* CBC
* Electrolytes
* UA
* CT of Sinuses
53
Which imaging test is specifically used to view the sinuses in tension headache diagnostics?
CT of sinuses
54
What are the primary **medications** used for **acute** treatment of **tension** headaches?
Aspirin, acetaminophen, NSAIDs
* These can be used alone or in combination with other medications.
## Footnote
These can be used alone or in combination with other medications.
55
Which **additional** types of medications can be **combined with NSAIDs** for tension headache treatment?
Sedatives, muscle relaxants, tranquilizers
## Footnote
These may enhance the effectiveness of primary medications.
56
Q: Why is **patient education** important in **migraine** management?
because **migraines are often triggered** by specific environmental or physiological factors, and identifying and avoiding these triggers can help with long-term management.
57
What is a **prodrome** in **migraines**?
* An **early symptom** that may precede the **onset of a migraine**, indicating its approach.
* early warning sign.
## Footnote
This phase can include sensory, motor, or psychic phenomena.
58
When do migraines typically begin?
After awakening; they may improve with sleep
59
List some associated symptoms of migraines.
* Nausea/vomiting
* Edema
* Irritability
* Sweating
* Photophobia: *light sensitivity*
* Phonophobia: *fear of loud sounds*
* Osmophobia: *sensitivity to smells*
## Footnote
These symptoms can significantly affect a patient's quality of life.
60
What percentage of patients with **MIGRANES** have a family history of the condition?
70%
* biggest risk factor for MIGRANES followed by high stress, frequent tension headaches, associated with triggers.
61
True or False: **Aura** is a common symptom experienced during a **migraine**.
True
62
What food is known to trigger headaches and is citrus-based?
Oranges
## Footnote
Oranges contain compounds that may provoke headaches in susceptible individuals.
63
Which vegetable is listed as a potential headache trigger?
Tomatoes
## Footnote
Tomatoes can contribute to headache onset due to their natural compounds.
64
Name a common ingredient in many foods that may trigger headaches, often found in **processed foods**.
Aspartame
* Aspartame is an artificial sweetener linked to headaches in some individuals.
65
Fill in the blank: _____ is a **stimulant** that can trigger headaches.
Nicotine
## Footnote
Nicotine may induce headaches due to its effects on blood vessels.
66
List two types of foods that are known to trigger headaches due to their **amine** content.
* Cheese
* Chocolate
## Footnote
Both cheese and chocolate contain substances that may lead to headaches.
67
What type of foods, commonly associated with **preservation**, may trigger headaches?
Fermented or marinated foods
## Footnote
These foods can contain high levels of amines, which are headache triggers.
68
Fill in the blank: _______ is a **common beverage** that can lead to headaches when consumed excessively.
Caffeine
## Footnote
Caffeine can cause withdrawal headaches if intake is reduced suddenly.
69
Which type of **alcohol** particularly triggers headaches?
Red wine
## Footnote
Red wine contains histamines and sulfites, which can contribute to headaches.
70
True or False: Ice cream is mentioned as a potential trigger for headaches.
True
## Footnote
Ice cream can trigger headaches, possibly due to its cold temperature or dairy content.
71
Name a type of food that contains **nitrates** and may trigger headaches.
Hot dogs
## Footnote
Nitrates are preservatives that can lead to headaches in some individuals.
72
What common **condiment** is listed as a potential headache trigger?
Vinegar
## Footnote
Vinegar can contain compounds that may provoke headaches in sensitive individuals.
73
Fill in the blank: Foods containing _______ are known to be headache triggers.
Monosodium glutamate
## Footnote
Monosodium glutamate (MSG) can cause headaches in some people after consumption.
74
List **2 common dairy products** that may **trigger** headaches.
* Ice Cream
* Cheese
## Footnote
Both ice cream and cheese can provoke headaches due to their dairy content.
75
Q: What is the key difference between **migraine with aura** and **migraine without aura**?
* **Migrane with Aura = Aura + prodrome**
*(Prodrome : early warning signs/symptoms)*
*(aura: visual disturbance symptoms)*
* **Migrane without Aura = Neither**
76
Q: What are the characteristics of a **migraine without aura**?
* Unilateral throbbing headache
* Possible N/V
* Complaints of phonophobia and photophobia.
77
Q: How does a **migraine WITH aura** typically progress?
A: It starts as a **unilateral** throbbing headache that **later becomes generalized**.
78
What **sensory symptoms** might a patient with a **migraine WITH aura** experience?
A: Visual disturbances and possible mood variations.
79
What medications are used for **mild migraine** therapy?
* acetaminophen
* ibuprofen (NSAID)
* ketorolac (NSAID)
## Footnote
These medications are considered first-line treatments for mild migraines.
80
What medications are used for **severe migraine** therapy?
opioids such as: **codeine & meperidine**
## Footnote
Refer to your facility formulary for specific guidelines and availability.
81
What are the common **antiemetics** used in **migraine** therapy?
* promethazine
* metoclopramide
* odansetron
Controls/treats N/V
## Footnote
Antiemetics are often prescribed to help alleviate nausea associated with migraines.
82
What is the purpose of **prophylactic** agents?
Prevention
## Footnote
Prophylactic agents are used to prevent conditions such as seizures or migraines.
83
List the 6 **#1 Approach** Prophylactic (prevention) agents for **migranes**
* Antiseisure meds
* Antihypertensives
* Antidepressants
* Serotonin antagonists
* Botulinum Toxin A
* Stress mgmt tecghniques
84
Approach No. 1
Name 2 **antiseizure** agents for **Migraine** tx.
* Valproate (Depakene)
* Topiramate (Topamax)
## Footnote
Antiseizure agents are utilized to manage epilepsy and other seizure disorders.
85
Approach #1:
3 **Antihypertensive** meds for **Migraines**
* B-Adrenergic Blockers
* Ca Channel Blockers
* Potassium channel Blockers
86
*Migranes*:
What class of medication does **propranolol** belong to?
ß -Adrenergic Blockers
* Propranolol is commonly used to manage hypertension and anxiety.
87
*Migranes*:
Identify a **calcium channel blocker** used as a prophylactic agent.
Verapamil
* Calcium channel blockers are often prescribed for hypertension and certain types of arrhythmias.
## Footnote
Dihydropyridines: end in -dipine
Non-dihydropyridines: diltiazem, verapamil
88
*Migranes*:
What type of medication is **amitriptyline**?
Antidepressant
* Amitriptyline is often used to treat depression and can also be effective in preventing migraines.
89
*Migranes*:
What is an example of a **serotonin antagonist**?
Methysergide (Sansert; Deseril)
## Footnote
Serotonin antagonists are used to prevent migraines by blocking serotonin receptors.
90
What is the role of **Botulinum toxin A** in treatment?
**Chronic** migraine management
## Footnote
Botulinum toxin A is used as a preventive treatment for chronic migraines.
91
List some **non-pharmacological** approaches to prevent **Migranes**.
* Stress management
* Exercise
* Biofeedback
* Trigger avoidance
* Hormones
## Footnote
These approaches can complement pharmacological treatments in preventing conditions.
92
What are the **#2 Approach** Symptom Relief agents for **Migranes**?
List 7
* a-Adrenergic blockers
* Serotonin receptors agonists (triptans)
* Analgesics
* Corticosteroids
* antiemetics
* combination drugs
* Gepant drugs
93
What are **α-Adrenergic blockers** used for?
Symptom relief for migraines
* Includes agents like ergotamine with caffeine (Cafergot) and DHE.
94
Name a class of drugs known as **serotonin receptor agonists.**
Triptans
* Examples include sumatriptan (Imitrex) and zolmitriptan (Zomig).
95
What is a **caution** to consider when prescribing **sumatriptan**?
Caution in CVD, HTN, CVA, and PVD
## Footnote
May exacerbate issues due to vasoactive effects.
96
List some **analgesics** used for migraine relief.
* ASA (aspirin)
* NSAIDs
## Footnote
ASA refers to acetylsalicylic acid.
Analgesics: relieve pain
97
What is the purpose of **corticosteroids** in migraine treatment?
Decrease inflammation
## Footnote
Helps in managing migraine symptoms.
98
Name 2 **antiemetics** that can be used for migraines.
* Ondansetron
* Promethazine
## Footnote
Antiemetics help alleviate nausea associated with migraines.
99
What are **combination drugs** for migraine relief?
α-Adrenergic blockers **with** triptans **with** analgesics **with** antiemetics
## Footnote
These combinations aim to provide **comprehensive** symptom relief.
100
What class of drugs are Gepants?
CGRP – calcitonin gene-related peptide receptor antagonists
101
What do Gepant drugs do?
They are used for migraine treatment with **less vasoconstriction**.
102
What is a potential **threat** associated with **gepant** drugs?
Hepatotoxicity threat
## Footnote
Requires monitoring of baseline liver function tests (LFTs).
103
Migranes:
Triptans: **Fast Onset/High Potency** Meds
104
Migranes:
Triptan: **Slow Onset/Low Potency** Meds
105
What is Dihydroergotamine (DHE) used for?
Treats migranes
106
What type of constrictor is Dihydroergotamine?
Venous and arterial constrictor
107
What are the routes of administration for Dihydroergotamine?
Given IV or IM
108
What is the half-life of Dihydroergotamine?
10-14 hour half life
109
Who should not be given Dihydroergotamine?
Patients with cardiac history
110
Is Dihydroergotamine safe to use during pregnancy?
Not safe during pregnancy
111
What type of drug interactions may Dihydroergotamine have?
Interactions with 'triptans' that potentiate vasoconstriction
*(Both vasoconstrict = incr. bp)*
112
What precautions should be taken when using Dihydroergotamine in certain patients?
Use with caution in ischemia and hypertensive patients
113
What side effects may occur with Dihydroergotamine?
May cause drowsiness/dizziness
114
What is the definition of migraine headaches?
A type of headache characterized by recurrent episodes of moderate to severe pain, often accompanied by nausea and sensitivity to light or sound.
## Footnote
Migraines can vary in duration and intensity.
115
List three characteristics or manifestations of migraines.
* Moderate to severe pain
* Nausea
* Sensitivity to light or sound
## Footnote
These symptoms can vary from person to person.
116
What are common triggers of migraine headaches?
* Foods containing tyramine
* Long periods between meals
* Menstruation and ovulation
* Alcohol
* Fatigue and sleep fluctuations
## Footnote
Identifying and avoiding these triggers can help manage migraines.
117
Fill in the blank: Foods that contain _______ should be avoided to help prevent **migraines**.
[tyramine]
118
What is a recommended **tool** for migraine management?
A paper or electronic headache diary.
## Footnote
This helps track headache patterns and triggers.
119
What lifestyle changes can help minimize the frequency of headaches?
Stress management and lifestyle changes.
## Footnote
Techniques may include relaxation exercises, regular exercise, and adequate sleep.
120
What should be ensured for correct pharmacologic management of migraines?
Acute therapy and prophylaxis, including medication regimen and understanding of side effects.
## Footnote
It's important to discuss medication options with a healthcare provider.
121
What comfort measures can be used during headache attacks?
* Resting in a quiet and **dark environment**
* Applying **cold** compresses to the painful area
* Elevating the head
## Footnote
These measures can provide relief during an attack.
122
True or False: Seeking resources for education and support is important for managing migraines.
True
## Footnote
Organizations like the National Headache Foundation can provide valuable information and support.
123
What are Gepant drugs?
* Used for **MIGRAINES**
* Used in acute or chronic migraines
* CGRP – calcitonin gene-related peptide receptor antagonists that cause **less vasoconstriction**
-blocks CGRP, which **causes inflammation and pain to the brain.**
* safer for pts with heart disease or high BP.
## Footnote
Gepants are a new class of medications used primarily for the treatment of migraines.
124
list 3 CGRP Receptor Agonists "Gepant" Meds
* Ubrelvy
* nurtec ODT
* Qulipta
125
What symptoms indicate a headache may require further evaluation?
* Symptoms become more severe, last longer than usual, or are resistant to medication
* Additionally, N/V (nausea/vomiting), changes in vision, or fever occurring with the headache may signal a need for evaluation.
126
What are the **concerning** signs that accompany headaches?
* Drowsiness
* lethargy
* obtunded (decr LOC)
## Footnote
These signs may indicate a more serious underlying condition related to the headache.
127
Fill in the blank: A headache accompanied by _______ should prompt further assessment.
N/V, change in vision, fever occuring with the headache.
128
Q: How can medication use contribute to headache issues?
Overuse of pain medications can lead to rebound headaches or drug-related complications.
## Footnote
This includes concerns about efficacy, side effects, and potential interactions.
