Neurology Flashcards Preview

ABIM > Neurology > Flashcards

Flashcards in Neurology Deck (280)
Loading flashcards...
1

Migraine

F>M
Q few weeks
1/2 hr onset
Lasts hours to days
Frontal/temporal one or both sides
Throbbing
n/v/aura/photophobia, AM menarch, menses, weahter, stress, worse with movement
Tx: Tylenol/NSAID/ASA -> Sumatriptan->chloropromazine/metochlopramide
Prevention: BB, TCA, Vit B2 (riboflavin), CoQ 10, Topiramate, Botox

2

Cluster h/a

M>F
1-2/day
onset 2-15min
lasts 1/2 hr-2hrs
Orbital/one side
Excruciating
Rhinorrhea, ipsilateral Horner's, Unilateral lacrimation
Tx: 100 OXYGEN, intranasal lidocaine, sumatriptan
Prevention: Verapamil, valproate, gabapentin

3

Tension h/a

F>M
How often? Variable
Onset Variable
how long 1/2hr to 7 days
Where: diffuse
Non-throbbing
Band like
Tx: analgesics
Prevention: BB, TCA

4

25yo F p/w chronic h/a x years noticed from puberty, mainly with waking up, several hours every few weeks, throbbing aw nausea and vom no auras - several tylenol and motrin didn't help - acute pain would respond to....

Sumatriptan

5

25yo F with FLASHES of light moving across eyes for a few minutes wiht loss of visio nin one eye - left homonymous defect -normal after 45 min

Dx: Migraine

6

Young woman co wk in R arm and leg - PMHx migraines - feels better after couple hours - carotid US, MRI brain and TEE normal dx?

Migraines
DO NOT USE TRIPTANS with CAD or vasculitides

7

52yo M p/w moderately severe befrontal throbbing ha - aw nausea - had h/a for past few years - normal temp - BP 150/90, fundoscopy normla neck supple, pupils reactive no focal neur effects histor significant for CAD wtd?

NSAID with prochloroperazine

8

Acute migrain with nausea and vomiting fastest relief?

SQ Sumitriptan

9

Severe acute migraine not responding to sumatriptan or lasting >72hrs

IV dopamin antagonist (prochlorperazine.metoclopramide) + IV diphenyhydramine (prevent acute dystonic rxn)

10

Severe acute migrain x more than 72hrs - last sumatriptan >24hrs ago with little response - >

parental dihydroergotamine

11

Pregnancy with migraine h/ once a week

tylenol or NSAID

12

Pregnancy with migraine h/a no response to NSAIDs

Metoclopramide or Chloroproazine or ondeansetron

13

Migraine ppx for h/a's how often?

2 times per week

14

PPX for migraine <15x/month

BB, amitriptyline, topiramate, sodium valproate

15

PPx for migrai >15/month

Topriamate-> botox

16

PPX migrains with asthma

amitriptyline, topiramate (no BB)

17

Prevention of menstrual h/a

mefenamic acid 2 days prior and upto end of menstruation

18

Migraine with Aura

OCP contraindicated!!

19

Pt with migrain h/a takes NSAIDs now not working wth h/a daily from morning to evening

Analgesic induced h/a
d/c all analgesics

20

42yo F chronic non-throbbing h/a worse at end of day - band like around neck

Tension h/a

21

35yo F c/o excruciating Ice pick like retroorbital h/a - h/o rhinorrhea, lacrimation ipsilateral horner's

Cluster h/a

22

Pt with recurrent h/a >5-6/day unilateral and retrooribtal

Chornic paroxysmal hemicrania
Tx: Indomethacin

23

32yo obese woman BMI>30 with daily h/a - horizontal diplopia - blurring of optic disc margins - spinal tap with inc'd pressure

Pseudotumor cerebri
Tx: Acetazolamide, lumboperitoneal shunt
Etio: obesity, Vit A toxicity, tetracycline, steroids, contraceptives, nitrofurantoin, isotretinoin, minocycline, danazol, tamoxifen, levothyroxine

24

Comoplications of pseduotumor cerebri

Peripheral visual field loss-> central visual field loss

25

Pt with known HTN with h/a and ataxia - CT scan large cerebellar bleed wtd?

surgery - brainstem compression

26

65yo h/a ESR 75

Temporal arteritis

27

H/a with rhinorrhea

Cluster h/a

28

100% O2

Cluster h/a

29

H/a with zigzag wavy lines photophobia and aura

Migraine

30

Sumatriptan

Migraine, Cluster h/a