CMN 568, UNIT 5, BBB-HEADACHES TEST WITH 100% CORRECT ANSWERS

Red flag: new onset on patient over 50 What is a thunderclap headache worst headache of your life, comes on quick. it is a red flag in adults is headache accompanied by fever a red flag for adults yes iis headache associated with recent head trauma a red flag for adults yes is vision changes with a headache something to be taken lightly no that is a red flag for adults if a patient has HIV, and a severe headache, and/or positive neurological findings is this a concern yes it is a red flag headaches associated with changes in personality are normal right? no that is a red flag for a headache for adults in children what is the age that a headache is a red flag under 5 years old fever and headache in children, NBD right? no, it is a red flag a child awakened in the middle of the night with a headache, is this normal? no, not ok!!! red flag headache with vomiting in children out of the blue, is this normal no, red flag. describe some more red flags in children HA worsed by straining or changes in posture neurocutaneous stigmata (cafe au lait sots or hypopigmentation) recent head trauma. 5 causes of headache that require URGENT (quick as you can) referral 1. Vacular 2. Infection 3. intracranial masses 4. Pre-eclampsia 5. Carbon monoxide poisoning what are some categories of vascular headache stroke, subarachnoid hemmorage, aneurism, malignant HTN, vasculitis what are some categories of infections brain abscess, meningitis, encephalitis intracranial masses could be a brain tumor what are some questions to ask during history about headaches (2 main points) 1. precepitating factors 2. associated symptoms: drooping eyelid, anxiety, visual changes, rhinorrhea, parathesias what good is a headache diary it discerns the pattern of HA, help in diagnsosing the type of headache. monitors interventions working, provide discussion for headache disorder and impact. what is an important psychosocial screen for patient headaches always screen for depression or anxiety disorders. should a fundoscopic exam be performed on people with c/o headaches yes what is the purpose of palpating the scalp and temoral arteries for tenderness on physical exam to check for temporal arteritis if a patient has RECCURENT headaches with NORMAL neuro exam you should still get a CT or MRI right? NO, only if they have a red flag symptom. what is the difference between primary and secondary headaches primary headaches are headaches that originate as a headache ( unlike secondary that are caused by something (like taking too many pills) types of primary headaches migraine, tension type headaches, cluster headaches do migraines always have to have an aura no cluster headaches are also known as (3 words) and is rare in____________ trigeminal autonomic cephalgia, children causes of secondary headaches intracranial lesions, head trauma, cervical spondylosis, TMJ/Dental problems, ocular problems, sinsitus, HTN, pseudotumor cerebri, depression, medication overuse what causes a migraine headache dilation of large blood vessels innervated by trigeminal nerve when do migraines usually start teens or early adulthood are migraines hereditary yes, usually there is a family hx of migraine common migraine triggers stress, lack of sleep/ fatigue, foods contaning nitrates, chocolate, alcohol, menstration, and oral contraception classic migraine symptoms worse when bedinging over, unilateral throbbing headache, worsened by activities what type of headache are visual hallucinations, paresthesias, and dysequalibrium associated with migraines what type of headache are anorexia, nausea, photophobia, phonophobia, visual changes, and cognitive impairment associated with, vomitting igraine when is migraine pain bilateral atypical pain or in children commonly bilateral difference between episodic and chronic migraine chronic migraine is greater than 15 days a month episodic migraine is less than 15 days a month how do you treat a migraine (3) avoid triggers, pharmacologic preventative therapy, treat attacks. two good tips for migraine sufferers take the medication as soon as earliest symptoms come on AND rest in a dark quiet room what kind of medication would you give for symptomatic relief of episodic migraine Cafergot (caffeine plus ergotamine) is first choice. can take q30 x 6 doses. Triptans are also good (all drugs in in triptan) triptans can be combined with naproxen. when to consider preventive medications for migraines for 2 to 3 migraines a month or significant disability during attacks. preventative migraine meds include 3 main categories antiepileptic and cardiovascular and antidepressents ALL taken daily what are some antiepileption medications for prevention of migraines topamax (topiramate) and Depokene (valproic acid) wha are some cardiovascular medications for preventing migraines Betablockers: propronolol, Timolol CCB: Verapamil what andtidepressant is used for daily use to prevent migraines anitriptyline (elavil) who should AVOID takng triptans? who should NEVER (contraindicated) take tripatans avoid in prenancy, hemiplegic or basilar migraines, hx of stroke or TIA, hx of DIABETES, hyperlipidemia, or obesity Contraindicated: coronary or PVD. when to take a triptan take at first onset of headache or prodrome (first onset symptom) most can repeat q2 hours for 2 doses in 24 hours what is the mainstay of pediatric headaches OTC analgesics. can you give an 11 year old almotriptan (axert) for episodic migraine/HA NO it is only approved for ages 12 and up wan you give an 11 year old Rizatriptan (Maalt) for episodic migraine/HA yes, they are approved for children 6 and older