Minicase - HA Flashcards Preview

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Flashcards in Minicase - HA Deck (21)
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1

W/u for migraine (4)

1. MRI brain (intracranial neoplasm)
2. CT head
3. CBC
4. ESR

2

W/u for cluster headache (4)

1. MRI brain (intracranial neoplasm)
2. CT head
3. CBC
4. ESR

3

W/u for temporal arteritis (6)

1. temporal artery biopsy
2. ESR (temporal arteritis)
3. CRP (temporal arteritis)
4. CBC
5. doppler U/S-carotid
6. MRI brain (intracranial neoplasm)

4

W/u for acute sinusitis (3)

1. CBC
2. XR sinus
3. CT sinus
(ddx inccludes tension headache, meningitis in which case you'd want the meningitis w/u below)

5

W/u for tension HA (4)

1. lytes
2. CBC
3. MRI brain (neoplasm)
4. LP w/ CSF analysis (pseudotumor cerebri w/ openig pressure)

6

W/u for SAH (8)

1. CT head w/o contrast
2. LP w/ CSF analysis and opening pressure
3. CBC
4. PT/PTT/INR
5. Urine toxicology
6. Digital subtraction angiography
7. MRI brain
8. CT angiography

7

W/u for meningitis (6)

1. LP w/ CSF analysis, opening pressure, gram stain, PCR, culture)
2. BCx
3. CBC
4. CT head w/o contrast (SAH, intracranial abscess)
5. MRI brain
6. PT/PTT/INR (SAH)

8

W/u for pseudotumor cerebri (6)

1. Urine hCG
2. LP w/ CSF analysis and opening pressure
3. dilated fundoscopy examination
4. funduscopic eye exam
5. MRI brain (intracranial neoplasm)
6. visual field testing

9

W/u for trigeminal neuralgia

1. MRI brain
2. CBC
3. ESR
(ddx includes: cluster HA, TMJ disorder, temporal arteritis)

10

Migraine hx findings (7)

1. HA
2. episodic
3. throbbing nature
4. unilateral
5. duration (hours to days, I think)
6. neurologic symptoms (N/V, aura, photophobia)
7. alleviation by rest/dark room

11

Cluster hx findings (6)

1. HA
2. gender and age- young male
3. unilateral
4. rhinorrhea, eye tearing and redness
5. episodic and same time at night
6. duration (~45 min)

12

Tension hx findings (5)

1. HA
2. bilateral
3. squeezing nature
4. episodic
5. associated with stress

13

Temporal arteritis hx findings (10, exam included as 1)

1. HA
2. elderly
3. episodic
4. unilateral
5. blurred vision
6. temporal location
7. weight loss
8. jaw pain when chewing
9. shoulder, hip pain
10. Exam: temporal TTP, reduced visual acuity

14

Acute sinusitis hx findings (6)

1. HA
2. frontal HA
3. fever
4. nasal dicharge
5. worsen when bend forward
6. hx of allergies

15

SAH hx findings (7)

1. HA
2. severe
3. acute
4. vomiting
5. confusion/AMS
6. FNDs (hemiplegia)
7. nuchal rigidity

16

Meningitis hx findings (6)

1. HA
2. confusion
3. photophobia
4. high fever
5. nuchal rigidity
6. consider exposures (dorms, army, etc)

17

Pseudotumor cerebri hx findings (8)

1. HA
2. obesity
3. female gender
4. blurred vision
5. pulsatile in nature
6. N/V
7. OCP use
8. frequency - daily for 2-3 wks

18

Trigeminal neuralgia hx findings

1. HA
2. elderly
3. unilateral
4. cheek location
5. triggered by touch
6. frequency - daily for month
7. duration - 1-2 minutes
8. stabbing and electric character

19

What is TMJ (temporomandibular joint) disorder?

- TMJ joint dysfunction
- crepitus with jaw movement
- pain with chewing

20

HA hx question nemonnic

1. OPQRST
2. AT&T WIRELESS

A - aura
T - timing (in OPQRST)
N - N/V
T - tearing, eye symptoms
W - wt loss
I - injury
E - estrogen exposure (OCPs)
L - leg (jt) pain
E - energy level (consititutional symptoms)
S - stress
S - speech difficulties

21

Basic HA differential (9)

1. migraine
2. tension
3. cluster
4. pseudotumor cerebri
5. sinusitis
6. meningitis
7. temporal arteritis
8. SAH
9. intracranial mass