Clinical Medicine II-Spring 2012
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| What are extracranially causes of HA’s | show 🗑
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| Intracranially causes of HA’s | show 🗑
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| Does the actual brain tissue (parenchyma) itself cause pain | show 🗑
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| show | adolescence or young adulthood, possible childhood. Rare to start in adulthood, suspect other causes.
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| Epidemiology of migraine HA’s | show 🗑
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| Two types of migraine HA’s | show 🗑
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| Characteristics of a common migraine | show 🗑
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| show | at least 5 attacks to dx w/ migraine HA’s
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| show | same as common but have an aura gradually prior to HA lasting <60min
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| What are the three types of aura | show 🗑
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| Does the aura resolve prior to HA | show 🗑
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| What can cause a Migraine HA | show 🗑
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| show | start by vasoconstriction followed by abnl vasodilation
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| Common prophylaxis for migraines | show 🗑
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| Common abortive tx of migraines | show 🗑
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| show | serious of HA’s over a period of 2-3m every 1-2 years M>F, onset late 20’s
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| What can trigger cluster HA’s | show 🗑
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| Clinical features of cluster HA’s | show 🗑
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| What are the autonomic features w/ cluster HA’s | show 🗑
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| show | high flow O2 inhalation 5-8L/m for 10 mins, effective ~70%, same as migraines
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| Proposed mechanism of cluster HA’s | show 🗑
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| show | tension headache, band like constriction around head, 30m-7days, PA unaffected, some photo/phonphobia, no N/V usually
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| Tx tension HA’s | show 🗑
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| show | sinusitis, acute glaucoma, temporal arteritis, TMJ, trigeminal neuralgia
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| show | Sinusitis: pain over sinuses, URI sx
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| show | acute glaucoma, cornea is often edematous, cunjunctiva is injected,
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| Dx of acute glaucoma | show 🗑
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| Jabbing excrutiating pain over the temple, unilateral or can be bilateral, visual loss may be present, often w/ other systemic sxs | show 🗑
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| Why is temporal arteritis so important to dx | show 🗑
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| Epidemiology of temporal arteritis | show 🗑
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| show | labs: elevated ESR, biopsy,
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| show | trigeminal neuralgia: brief, severe attacks in distribution of branch of trigeminal n. pain is lancinating “electric shop”
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| show | D/t partial demylinization of trigeminal n. possible d/t n. compression, triggered by eating, talking, washing face
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| show | analgesics, narcs, anti-sz
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| Name 5 life threatening HA’s | show 🗑
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| What is a diagnostic feature of a SAH | show 🗑
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| show | LOC, focal neuro signs, sz, nuchal rigidity, CT, -? Then do LP!
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| show | around the Circle of Willis
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| What does acute blood look like on a CT? | show 🗑
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| show | Nimodipine (CCB); vasodilator, phenytoin, and urgen neurosurgical consultation
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| Sxs Dx and tx of Meningitis | show 🗑
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| show | S: sickle, H: lenticular shaped, like a lense
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| Story of a subdural hematoma | show 🗑
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| show | E: artery bleed: more serious, S: venous bleed
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| Story of an epidural hematoma | show 🗑
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| What classifies a HTN HA | show 🗑
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| show | brain tumor HA
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| Complaints of a brain tumor | show 🗑
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| Study of choice to dx a brain tumor | show 🗑
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| 4 types of brain tumors | show 🗑
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| show | astrocytoma, in cerebral hemispheres
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| Histopathological grading of a astrocytoma | show 🗑
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| show | radiation, some genetics,
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| Tx astrocytoma | show 🗑
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| show | meningioma, on surface of brain in concavity of skull, mostly benign
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| Tx meningioma | show 🗑
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| Acoustic neuroma, RF’s | show 🗑
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| Unilateral HL MC complaint | show 🗑
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| show | surgical excision to preserve hearing, If not surgical candidate: gamma knife to reduce size, maybe just observe in elderly or if sm
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| Complication of surgical excision | show 🗑
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| show | Lung, Breast, Genitourinary, Osteosarcoma, Melanoma, GI
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| show | when there are more than one tumor in the brain, check other sources
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| show | avoid surgery, whole-brain radiation therapy, gamma knife: but subclinical lesions are most likely present, chemo
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| What are surgical indications for brain mets | show 🗑
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Created by:
streetsmarts
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