Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHA333 > Wk 28 - CNS + MSK OTC > Flashcards

Wk 28 - CNS + MSK OTC Flashcards

1
Q

Give examples of types of headaches

A
  • Migraine
  • Tension headache
  • Sinusitis
  • Cluster headaches
  • Temporal arteritis
  • Trigeminal neuralgia
  • Chronic daily headache
  • Medication overuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a migraine?

A
  • Complex neurological condition
  • Severe/moderate headache
  • Throbbing + pulsating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the key feature that support the diagnosis of migraines?

A
  • Nausea + vomiting
  • Photophobia
  • Phonophobia
  • Disability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of a migraine?

A

Vasodilation of blood vessels in brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Outline the main classifications of migraines

A
  • Migraine w/ aura
  • Migraine w/o aura
  • Chronic migraine
  • Menstrual migraine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give examples of migraine w/ aura

A
  • Typical aura
  • Hemiplegic migraine
  • Migraine w/ brainstem aura
  • Ocular
  • Silent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Outline the features of migraine w/o aura

A
  • Recurrent headache
  • Attacks last 4-72 hrs
  • Unilateral, pulsating, mod/severe
  • Aggravated by physical activity
  • Association w/ nausea, vom, photophobia + phonophobia
  • Relief from lying in darkened room
  • No neurological symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Outline the features of migraine w/ aura

A
  • Transient, unilateral
  • Visual, sensory + other CNS symptoms that develop gradually
  • Occurs 5-20 mins before headache
  • Prodromal + post-dromal phases occur
  • Neurological symptoms precede headache
  • More common in women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Visual aura

A
  • Flashing lights
  • Scotoma
  • Zigzag lines (photopsia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sensory aura

A
  • Unilateral tingling or numbness in lips, fingers, face + hands
  • Difficulty in speaking (dysphasia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the ICHD-3 diagnostic criteria for migraine w/o aura?

A
  • > 5 attacks fulfilling 3 criteria
  • Headache lasting 4-72 hrs

2/4:

  • Unilateral
  • Pulsating
  • Mod/severe pain
  • Aggravated by physical activity

During headache at least 1 present:

  • Nausea and/or vom
  • Photophobia + phonophobia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the ICHD-3 diagnostic criteria for migraine w/ aura?

A

> 2 attacks fulfilling 3 criteria

1/more:

  • Visual
  • Sensory
  • Speech
  • Motor
  • Brainstorm
  • Retinal

At least 3:

  • At least 1 aura symptom gradually over 5 mins
  • 2/more aura symptoms
  • Each symptom lasts 5-60 mins
  • 1 unilateral
  • 1 +ve
  • Aura accompanied w/in 60 mins of headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give an example of a diet trigger for migraine

A
  • Crash diet
  • Irregular meals
  • Cheese
  • Chocolate
  • Red wine
  • Tyramine containing foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give an example of an environmental trigger for migraine

A
  • Smoking
  • Bright light
  • Screen use
  • Strong smell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give an example of an psychological trigger for migraine

A
  • Depression
  • Anxiety
  • Stress
  • Anger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give an example of medicinal triggers for migraine

A
  • HRT

- COC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give other examples of triggers for migraine

A
  • Menstruation
  • Shift pattern
  • Menopause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give treatment options OTC for acute migraine

A
  • Simple analgesia
  • Anti-emetic
  • Migraine specific treatment: triptans or 5HT1 agonist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give examples of simple analgesia for migraines

A
  • Paracetamol
  • Ibuprofen
  • Aspirin

Use early in attack to avoid gastric stasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give examples of anti-emetics used for migraines

A

Gastric stasis slowed in migraine (red med absorption)

  • Migraleve pink: codeine, paracetamol + buclizine
  • Buccastem M buccal: prochlorperazine 3mg - previously diagnosed migraine + adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do serotonin 5-HT1 agonists or triptans work to reduce migraines?

A
  • Imitate 5-HT
  • 5-HT causes dilated blood vessels to constrict
  • Included 1st line along simple analgesia + anti-emetic in mod/severe migraine
  • Red pain w/in 2 hrs
  • Red photophobia + phonophobia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Give examples of triptans

A
  • Almotriptan
  • Naratriptan
  • Sumatriptan
  • Zolmitriptan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the criteria to supply sumatriptan (imigran)?

A
  • 18-65
  • Migraine diagnosed by doc/pharmacist
  • Established pattern of migraine w//w/o aura (5/more over year)
  • Simple analgesic ineffective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Outline the cautions for sumatriptan use

A
  • SSRI/SNRI
  • St Johns wort
  • COC
  • Heart disease risk factors
25
Q

What are the contraindications of sumatriptan?

A
  • Under 18, over 65
  • Pregnant + breastfeeding
  • 3/more cardiovascular risk factors
  • Aged 50 + over + experiencing migraine attack for 1st time
  • 1st ever migraine attack w/in previous 12 months
  • Fewer than 5 migraine attacks in past
  • Don’t respond to treatment
  • Headache on 10/more days per month
  • COC
  • 4/more attacks per month
  • Migraine lasting over 24hr
26
Q

Outline how to take sumatriptan

A
  • One 50mg tablet
  • Taken asap - start of headache + not start of aura
  • 2nd dose taken 2 hrd after 1st if symptoms back - only if headache responded to 1st dose
  • Don’t take more than 2 in 24hrs
  • Don’t take more than 2 for same attack
27
Q

When should sumatriptan be considered as a preventative treatment?

A
  • Migraine attacks have sig impact on QoL
  • Acute treatments are contraindicated or ineffective
  • Person is risk of MOH due to frequent use of acute drugs (amitriptyline, propranolol, topiramate)
28
Q

Give counselling point for a migraine

A
  • Keep headache diary to identify triggers
  • Immediate use of simple analgesia
  • Dark + quiet env
  • Good sleep hygiene
  • Diet + fluid intake
  • COC
  • Cold compress
29
Q

What is tension type headache?

A
  • Most common type of headache
  • Recurrent episodes of headache that are bilateral
  • Pressing/tightening band around head (non-pulsating)
  • Mild to moderate
  • Relationship to neck w/ pain into/from neck
  • Mild nausea
  • Relieved by simple analgesics
30
Q

What are the different types of TTH?

A
  • Episodic: fewer than 15 days each month

- Chronic: more than 15 days each month + has ft of episodic TTH

31
Q

What causes TTH?

A
  • Anxiety
  • Screen time
  • Depression
  • Poor posture
  • Poor sleep
  • Stress
  • Muscular tightness
32
Q

What are the treatments for TTH?

A
  • Simple analgesics: paracetamol, ibuprofen
  • Syndol tabs: codeine, paracetamol, doxylamine + caffeine
  • Syndol headache relief: codeine, paracetamol + caffeine
  • Avoid codeine prods
33
Q

Give counselling advice for TTH

A
  • Lifestyle adjustments
  • Alleviate stress
  • Check sleep hygiene
  • Attention to anxiety/depression
  • Advice on posture
  • Exercise
  • Red use of screens
  • Avoid codeine
  • Acupuncture
34
Q

When should you refer when experiencing a headache

A
  • Migraine w/ COC
  • Headache w/ associated high temp
  • Frequent migraine/treatment failure
  • Severe headache of >4hrs
  • Suspected ADR
  • Associated drowsiness, unsteadiness, visual disturbance or vomiting
  • Associated neck stiffness
  • Suspected injury/trauma
  • Under 12
35
Q

What are the different types of MSK pains?

A
  • Myalgia from injury, infection, cramp
  • Bone pain: fracture, infection, tendon pain from sprain, strain or inflammation
  • Joint pain: RA/OA/Gout
  • Bursitis
  • Fibromyalgia: pain in tendons, muscles + joints
  • Nerve compression pain: put pressure on nerves (carpal tunnel syndrome)
36
Q

Low back pain

A
  • 60% people experience
  • Pain in lumbosacral area of back btw bottom of rib + top of legs
  • Usually due to trauma or musculoligamentous strain
  • Acute resolve w/in 6 wks
37
Q

Give counselling advice for lower back pain management

A
  • Stay active, avoid bed rest (leads to loss of muscle strength + inc stiffness)
  • Inc physical activities over few days or wks
  • Relaxation red tension
  • Local heat/ice pack
38
Q

Pain analgesia for lower back pain

A
  • Offer NSAID first line: ibuprofen 400mg TDS
  • Paracetamol not enough
  • If NSAID not tolerated or ineffective offer codeine
39
Q

Other than pain analgesia, what can be used to manage lower back pain?

A

Topical NSAIDs

  • Less systemic absorption
  • Ibuprofen gel: ibuleve
  • Diclofenac gel: voltarol

Rubefacients: heat rubs

Cooling sprays

40
Q

What is a sprain?

A
  • Stretch/tear of ligament
  • Result of joint being forced suddenly outside usual range
  • Symptoms: pain round affected joint, tenderness, pain weight bearing
  • Ankles, knees, wrists + thumbs
41
Q

What is a strain?

A
  • Stretch/tear of muscle fibres and tendon
  • Stretched beyond limit + forced to contract too strongly
  • Symptoms: muscle pain, inflammation, spasm
  • Foot, hamstring + back
42
Q

What is the management for a strain/sprain?

A
  • Oral analgesia: paracetamol/NSAIDs + price
  • Oral NSAIDs: ibuprofen OTC
  • Topical NSAID
43
Q

What are the red flags for MSK?

A
  • Severe arthritis
  • Back pain w/ abnormal urination
  • Back pain radiating to leg
  • Suspected fracture
  • Head injury
  • Treatment failure
  • Suspected adverse drug reaction
44
Q

What is insomnia?

A
  • Unsatisfactory sleep
  • Difficulty in sleeping, difficulty maintaining sleep, early wakening results in impaired daytime functioning or wellbeing
  • Associated w/ inc age
45
Q

What are the common complaints of daytime effects in patients w/ insomnia?

A
  • Fatigue
  • Tiredness
  • Lack of energy
  • Irritability
  • Red work performance
  • Difficulty conc
46
Q

Give physical causes of insomnia

A
  • Pain
  • Nasal congestion
  • COPD
  • Pregnancy
47
Q

Give physiological causes of insomnia

A
  • Circadian rhythm disorders

- Poor sleep hygiene

48
Q

Give psychological causes of insomnia

A
  • Stress

- Bereavement

49
Q

Give psychiatric causes of insomnia

A
  • Anxiety
  • Depression
  • Dementia
50
Q

Give pharmacological causes of insomnia

A
  • Stimulants
  • Steroids
  • Decongestants
  • Thyroxine
51
Q

Outline the classifications of insomnia

A
  • Transient (days)
  • ST (4wks)
  • Chronic (>4wks - refer)
52
Q

Give examples of non-pharmacological treatment for insomnia

A
  • Sleep hygiene
  • Regular sleep schedule
  • Avoid napping
  • Caffeine avoided after midday + nicotine, alcohol + large meal w/in 2 hrs of bedtime
  • Exercise during day, avoid close to bedtime
  • Avoid clock watching
  • CBT
  • Relaxation techniques
53
Q

Give examples of relaxation techniques for insomnia

A
  • Relaxation before bed
  • Regular daily exercise but avoid w/in 4 hrs of bedtime
  • Stress management
  • Acupuncture
54
Q

Give examples of sedative antihistamines

A
  • Diphenhydramine

- Promethazine

55
Q

Diphenhydramine

A
  • Nytol original
  • Nytol one a night
  • Recommend no longer than 7 consecutive nights (SPC 14 nights)
  • Not for under 16
  • S/e: anticholinergic, hangover effect
  • Contraindications: Prostatic hypertrophy, closed angle glaucoma, pregnancy + breast feeding
56
Q

Promethazine

A
  • Sominex
  • Phenergan (10mg + 25mg)
  • HL: 8-12hrs (longer acting + more sedative
  • No longer than 7 consecutive nights
  • Not for under 16
  • S/e: anticholinergic, hangover effect
  • Contraindications: Prostatic hypertrophy, closed angle glaucoma, pregnancy + breast feeding
57
Q

What are complementary therapy for insomnia?

A
  • Herbal sleep aids: valerian root extract, hops, passion flower, jamaica dogwood, nytol herbal
  • Aromatherapy: lavender/camomile oil
  • Nasal plaster
58
Q

Give examples of red flags for insomnia

A
  • Suspected depression
  • Chronic issue (>4 wks)
  • Children <16
  • Associated physical conditions
  • Suspected alcohol/drug dependence

PHA333 (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions