headache d2

Question 1

HA/migraine/

demo/sx/

Answer 1

demo: w_omen in their tee^{ns or 2}0s.

sx:

1. Mode_{rate to sever}e u^nilateral thr^obbing ;
2. di^sabling HA
3. sometimes ass. w. a^ura =20 ^{min of} sta_{rs or fla}shes b4 the HA

hint: think about it in terms of O, T, RR, QS, PP, assS

Question 2

HA/migraine/

important QUESTIONS to ask and tests to dx it?

Answer 2

P^OUNDi_ng questions+

ex_clusion o^{f 2a}ry HA

Question 3

HA/tension HA/

sx/

“disable” the pt?

Answer 3

sx:

1. C_hronic;
2. _Bilateral + squi^{zzing pre}ssur_e-type HA
3. mi_{ld to mode}rate intensity/

*sel_{dom sev}er^{e eno}ugh to => re^{al disab}ility.

Question 4

HA/tension/

important tests

Answer 4

excl^{usion of sec}ond^{ary hea}daches

Question 5

HA/Cluster headaches/

demo/

sx/

ass. W. or

signs

Answer 5

demo:youn^{g m}en; in th_{eir 20}s

sx:

1. U_nilateral HA;
2. wo_{rst arou}nd the orb^{it or tem}po^{ral are}a;

ass/ w.

1. con_junctiv^{al inje}ction;
2. lac_rimation; or
3. nas_{al con}gesti^{on= rhino}rrhea.

Question 6

HA/Cluster headaches/

important tests

Answer 6

exclusion of sec^{ondary head}aches

hint: secondary ha= VIN= vascular, infection, neoplasm

Question 7

HA/Intracranial aneurysm HA/

sx/

Answer 7

Ac_{ute or subac}ute HA

HA featur_{es are} no^nspecific

Question 8

HA/Intracranial aneurysm/

important tests

Answer 8

a_ngiogra^phy: CT or MR or traditional

Question 9

HA/Brain tumor/

riskfactors/

sx or signs

Answer 9

H_{<u>x</u> of ma}lig^nancy

PE:Fo_{cal neu}rologi^{c def}icit

Question 10

HA/Brain tumor/

important tests

Answer 10

C_{NS i}ma^ging

Question 11

HA/Substance exposure= CO/

sx/

Answer 11

sx:

start: occ.in an exp^{osed coh}ort +
stop: resol_{ves up}on leav_{ing sit}e of exp^osure

Question 12

HA/Substance exposure=CO/

important blood tests

Answer 12

C_arboxy_Hemoglobi^{n le}vels

Question 13

HA/Morning headaches as sx of nighttime hypoglycemia/

demo/

riskfactors/

Answer 13

Most comm_{on in diab}etics w. rece_nt

1. _medication or
2. di_{et chan}ges

Question 14

HA/Morning headaches as sx of nighttime hypoglycemia/

important tests

Answer 14

2_{:00 A}M glu_cose lev^el

hint: test at 2AM

Question 15

HA/Morning headaches as sx of obstructive sleep apnea/

riskfactors/

sx/

Answer 15

risk factors:O_besity

sx= dayti^{me som}nol_ence

Question 16

HA/Morning headaches as sx of obstructive sleep apnea/

important tests

Answer 16

P_olysomn^ogram= sle^{ep st}udy

Question 17

HA/Temporal arteritis/

riskfactors/

sx/signs

Answer 17

ck risk factors: po_lymyalgi^{a rhe}uma^tica/

sx:

1. Thr_obbing HA;
2. po_lymyalgia rhe^umatica
3. Temp_{oral arter}y ab^normalities (

• such as pro^minence; ten_derness; be^ading)

Question 18

HA/Temporal arteritis/

important tests

Answer 18

1. Er_ythrocyte se^dimentati_{on rat}e= ESR
2. Tempo_{ral art}ery bi^opsy

Question 19

HA/Benign thunderclap headaches

/sx

Answer 19

I^ndistinguis_{hable fr}om SA^H

Question 20

HA/Benign thunderclap headaches/

important tests

Answer 20

mm test as SAH =

• No^ncontrast hea_{d CT} scan+ Lum^{bar pu}ncture

Question 21

HA/Intracerebral hemorrhage/

sx/

signs

Answer 21

Headache with fo_{cal neu}rolo^{gic si}gns

Question 22

HA/Intracerebral hemorrhage

/important test

Answer 22

Noncon_{trast he}ad C^{T s}can

Question 23

HA/SAH or sentinel HA/

demo/

sx/signs

Answer 23

demo:midd_le-aged ^pt

sx:

1. “the wo_{rst hea}dach^{e of} his life.”
2. Soon af_{ter the H}A begins;

• Pt v_omits and
• develops ne_{ck p}ain and st^iffness or
• _{NS def}icit + me^ningismus

Question 24

SAH vs sentinel HA?

Answer 24

sentinel HA and SAH: present the mm way but sent^{inel H}A reso^{lve w/i}n 24 hrs

Question 25

HA/**Idiopathic intracranial hypertension**/ demo/ riskfactors/ sx/signs

Answer 25

_demo:_Fem_{ale gen}der _risk factors_:Ob^esity _sx_:Sev_{ere he}adac^he

Question 26

HA/**Idiopathic intracranial hypertension**/ important tests

Answer 26

1. P_apillede^ma 2. Exclus_{ion of seco}ndary caus^{es of intracr}anial hypert^ension

Question 27

HA/**Subdural hematoma**/ demo/ riskfactors/

Answer 27

_demo:_El_derly pts w a _hx_ of 1. fa^lls or 2. a_nticoagu^lation

Question 28

HA**/Subdural hematoma**/ important tests

Answer 28

No_ncontrast hea^{d C}T scan

Question 29

HA/**Meningitis**/ sx/signs

Answer 29

acu^{te onse}t of **triad** : 1. H_A; 2. f^ever+ 3. a sti^{ff ne}ck

Question 30

most common cause of meningitis

Answer 30

V_{iral cau}ses =**3–4** times +++ common than ba_cterial causes

Question 31

**Bacterial meningitis** must be treated as a **medical emergency**?

Answer 31

yes!!!