Headache
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Headache - Leaderboard
Headache - Details
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34 questions
| 🇬🇧 | 🇬🇧 |
| How is headache examined | Blood pressure Palpation - temporal arteries - sinuses Temperature Neck examination Fundoscopy |
| What is general approach for management of headache | Reassurance, hydration, optician review Headache diary - identify and avoid triggers |
| What are red flags for a headache | Age above 50 Thunderclap headache Progressive/persistent Previous head injury |
| Difference between primary and secondary headache | Primary - Non identifiable - Common (90%) - Generally not life threatening Secondary - Symptom of underlying disease - Uncommon - May be life threatening - Sinusitis, SOL, Haemorrhage, Meningitis |
| What is general approach for management of headache | Reassurance, hydration, optician review Headache diary - identify and avoid triggers |
| What are red flags for a headache | Age above 50 Thunderclap headache Progressive/persistent Previous head injury |
| How is headache examined | Blood pressure Palpation - temporal arteries - sinuses Temperature Neck examination Fundoscopy |
| NA | NA |
| What are red flags for a headache | Age above 50 Thunderclap headache Progressive/persistent Previous head injury |
| How is headache examined | Blood pressure (high contributes) Palpation - temporal arteries - sinuses Temperature Neck examination (movements) Fundoscopy - back of the eye |
| Where is tension headache likely to occur | Bilateral, frontal-temporal |
| What is general approach for management of headache | Reassurance, hydration, optician review Headache diary - identify and avoid triggers |
| How is headache examined | Blood pressure Palpation - temporal arteries - sinuses Temperature Neck examination Fundoscopy |
| How is headache examined | Blood pressure Palpation - temporal arteries - sinuses Temperature Neck examination Fundoscopy |
| How is headache examined | Blood pressure Palpation - temporal arteries - sinuses Temperature Neck examination Fundoscopy |
| What is general approach for management of headache | Reassurance, hydration, optician review Headache diary - identify and avoid triggers |
| What is general approach for management of headache | Reassurance, hydration, optician review Headache diary - identify and avoid triggers |
| What is general approach for management of headache | Reassurance, hydration, optician review Headache diary - identify and avoid triggers |
| What is the cause of tension headache and how is it treated | Cause - Stress/depression Treatment - Simple analgesia - Does not reduce recurrence and may lead to secondary headache - Stress management - NSAIDS, aspirin, paracetamol |
| Where is migraine likely to occur | Unilateral, throbbing and disproportionally disabling |
| Difference between classical migraine and common migraine | Classical Migraine (10-30%) - Migraine with aura (neurological change, usually visual symptom) Common Migraine (70-90%) - Migraine without aura |
| What are managements for migraine | Analgesia Antiemetic Triptans |
| What are specific symptoms leading to diagnosis of cluster | Excruciating and restlessness Increased tear production Redness of eyes |
| Treatment for Cluster | DO NOT suggest simple analgesia - does not work Short burst of oxygen therapy Injecting or intranasal triptan |
| How would patient present with Trigeminal neuralgia | Sudden severe facial pain Shooting/Burning sensation Triggered by light touch |
| Treatment for Trigeminal neuralgia | Carbamazepine - If cannot use it, refer it to specialist |
| What drugs may lead to Medication overuse headache | Chronic use (over 10days) of these drugs - Paracetamol - NSAIDs - Opioids - Triptans |
| Treatments for medication overuse headaches | Rebound phenomenon - Pain gets worst when they stop painkillers However, resolves with discontinuation within 2 months |
| What differentiates from viral or bacterial infection of sinusitis | Bacterial infection (2%) - blood/pus production - Creamy discharge from nose or throat Majority is viral infection |
| What are symptoms of Sinusitis | Tenderness Fever Rhinitis |
| What is space occupying lesion | Primary/Secondary brain tumour (from Lung, breast, Bowel, Kidney, Skin) - primary way more common Abscess or Haematoma |
| What are symptoms and signs or SOL | Symptoms - Progressively worsening morning - due to raised intercranial pressure - Vomiting - Seizure Signs - Altered GCS - Cushing's triad (Low heart rate, respiratory rate, increased blood pressure) - Papilloedema |
| What is subarachnoid haemorrhage | Bleed into subdural space - following rupture of vein Neurological emergency It may be result of berry aneurysm, AV malformation, traumatic head injury |
| How would pateints present with subarachnoid haemorrahge | Thunderclap headache - worst headache in their life Meningism - neck stiffness, photophobia Nausea Altered vision Drowsiness |
| What are examinations for SAH | CT/MRI Cerebral spinal fluid becomes xanthochromic - Lysis of RBC resulting in haemoglobin breaking down to bilirubin |
| What is meningitis | Inflammation of meninges - bacterial or viral infection Life threatening which can mimic influenza |
| What are symptoms of meningitis | Headache Fever Stiff neck Non-blanching purpuric rash Opisthotonos - Arched body with neck hyperextended Kernig's sign - Pain when knee extended with hip flexed |
| What bacteria causes meningococcal Septicaemia | Neisseria Meningitidis (meningococcus) |
| Why is Meningococcal Septiciaemia a paediatric emergency | Impacts clotting cascade - Failure in coagulation Leads to risk of sepsis |
| What is Temporal arthritis (Giant cell arthritis) | Auto-immune inflammatory vasculitis |
| What age group is prone to temporal arthritis and which gender is more vulnerable | Rare under 50 More common in women |
| Why is temporal region painful for patients with temporal arthritis | Temporal region supplied by temporal artery Due to inflammation, pain Pain may radiate to temples and jaws May lead to Jaw claudication |