OAT Head Pain

Question 1

worst headache of life

Answer 1

SAH

Question 2

new onset focal neurologic weakness

Answer 2

stroke

Question 3

onset headaches at >50 yr old

Answer 3

temporal arthritis

neoplasm

Question 4

associated systemic symptoms

Answer 4

meningitis

encephalitis

Question 5

acute eye pain

Answer 5

acute angle glaucoma

Question 6

high blood pressure

Answer 6

hypertensive urgency/emergency

preeclampsia

Question 7

Tension Headache Pain Pattern

Answer 7

bilateral tight/achy pain

radiation from occipital/cervical region

Question 8

tension headache etiology

Answer 8

cervicogenic C1-3

trigeminal cervical complex

Question 9

tension head common causes

Answer 9

myofascial pain referral
cervical facet referral
TMJD

Question 10

Myofascial pain referral

Answer 10

Tension headache
due to overuse or injury to muscles
generates a trigger point

Question 11

trigger point

Answer 11

seen in myofascial pain in tension headaches
palpable knot in muscle
palpation creates a twitch response
reproduces pain pattern

Question 12

Conservative tx for myofascial pain

Answer 12

manual manipulation - ischemia compression
PT
Spray and stretch
dry needling

Question 13

Cervical Facet referral

Answer 13

tension headache
due to degeneration/arthritis, injury, overuse/poor posture
generated by the cervical facet joint capsule

Question 14

cervical facet sxs

Answer 14

palpation of joint reproduces sxs
protective muscle spasms during movement
painful loss of range of motion

Question 15

cervical facet tx

Answer 15

RICE
Conservative
Pharm
Injection

Question 16

TMJD causes

Answer 16

tension headache
malocclusion
disc displacement/joint degeneration
myalgia

Question 17

TMJD pain generators

Answer 17

intra-articular - joint

extra-articular - pterygoid m., temporalis m., masseter m.

Question 18

TMJD associated sxs

Answer 18

decreased ROM of jaw
clicking of joint
pain with opening/closing/chewing

Question 19

TMJD tx

Answer 19

bite splint, stretching
conservative
pjarm
trigger point injection
surgery contraindicated

Question 20

Preventive Tension headhace

Answer 20

SSRI, tricyclics

smoking cessation

Question 21

Migraine pain pattern

Answer 21

unilateral throbbing burning pain
may shift
multiple phases

Question 22

migraine associated sxs

Answer 22

aura
NAUSEA
photophobia
phonophobia

Question 23

Migraine phases

Answer 23

premonitory - fatigue, irritability, difficulty speaking/reading
aura
headache
postdrome - fatigue, inability to concentrate/comprehend

Question 24

Migraine subtypes

Answer 24

migraine without aura
migraine with aura
hemiplegic migraine
migraine and vertigo
abdominal migraine
retinal migraine

Question 25

Migrane triggers

Answer 25

``` emtional stress hormones irregular sleep diet caffeine and alcohol weather dehydration smells meds ```

Question 26

miagraine etiology

Answer 26

cortical spreading depression theory depolarization of ion channels cuases spreading wave of neuro depression inappropriate nociceptive sensitization of trigeminocervical pain

Question 27

migraine tx

Answer 27

manipulation decreases number of migraine days accupuncture - evidence of some prophylaxis triptan, ergots avoid triggers

Question 28

Medication rebound define

Answer 28

chronic pain med use | >15day/month for 3 months

Question 29

medication rebound pain generator

Answer 29

chemical dependence on med

Question 30

medication rebound pain generator sxs

Answer 30

headache recurring around the same time every day | always relieved with taking the same meds

Question 31

medication rebound tx

Answer 31

stop offending medication to break the cycle

Question 32

Cluster headache pain pattern

Answer 32

trigeminal autonomic cephalgias | unilateral brief cycles

Question 33

cluster headache sxs

Answer 33

``` autonomic sxs sweating swelling tearing stuffy/runny nose ```

Question 34

cluster headache etiology

Answer 34

hypothalamic activation triggers trigeminal autonomic reflex

Question 35

cluster headache tx

Answer 35

``` oxygen triptan ergos intranasal lidocaine prophylaxis - verapamil ```