Pathophysiology Exam 1 UTMB Questions
With Verified Answers
Migraine without Aura
85% of migraines, pulsatile, throbbing, unilateral, can last 4-72 hours, aggravated by physical activity,
can be accompanied by N/V, sensitivity to light, sounds, smells, and visual disturbances
Migraine with Aura
15% of migraines, pulsatile, throbbing, unilateral, aggravated by physical activity, can be accompanied
by N/V, sensitivity to light, sounds, smells, and visual disturbance, develops over 5-20 mins and can
last an hour, usually genetic
Static Migranosis
Migraine lasting longer than 72 hours, need to be admitted for IV pain relief
Cluster Headache
Severe, unilateral, 15 min-3 hour headache. Can have for weeks or months at a time, sxs disappear
then come back. Hereditary.
Tension Headache
Hat-band type pain, usually not debilitating, dull, aching headache
Chronic Daily Headache
15 or more headaches per month, could be due to medication overuse, caffeine, etc.
Non-Pharmalogical measures for migraine treatment
-Control risk factors and triggers-stress, sleep deprivation, alcohol, foods (eg. chocolate, msg, aged
cheese), visual stimuli, estrogen.
-Behavior interventions-stress management, biofeedback, relaxation therapy, cognitive therapy
-Avoid aggravating factors (specific to person)
First line severe headache treatment
Anti-seizure meds, non-narcotics, narcotics, NSAIDS, triptans, ergotamine, midrin
Acute non-responder care for headaches (20-25% don't respond to first line treatment)
Reglan, prophylaxis, beta blockers for prevention
Seizure vs Epilepsy
Epilepsy: chronic state of recurrent seizures
Seizure: temporary disturbance in brain activity causing nerves to fire excessively
Provoked seizures
Fever (common in children), electrolyte imbalances, hypoglycemia, CNS infection or damage,
meningitis, hypoxia, eclampsia, tumors
Partial (focal) seizures w/o impairment of consciousness
, somatosensory disturbances, involuntary motor movement, autonomic nervous system may be
affected (sweating, tachycardia, hyper/hypotension, pupil changes)
Partial (focal) seizures with impairment of consciousness
Occur in temporal lobe, can start here and then move to other areas. Psychomotor symptoms-lip
smacking, petting clothes, eating. Can have feelings of deja vu, fear, hallucinations, commonly
confused with psych disorders. Confusion postictally is common.
Generalized seizures
seizures that involve the entire brain, can all be followed by Todd's paralysis for 24 hours (temporary
paresis, hemianopia, aphasia-speech/understanding). Include tonic-clonic, absence, myoclonic, tonic,
clonic, and atonic seizures
tonic-clonic seizure (grand mal)
generalized seizure in which the patient loses consciousness and has jerking movements of paired
muscle groups, loss of bladder and bowel control
Absence seizures (petit mal)
Occurs during childhood, stares off with little to no tonic-clonic movement, brief unresponsive
episode, MORRIS
myoclonic seizure
quick, repetitive jerks of the face, trunk, or 1 or more extremities
Tonic seizure
-Stiffening & extension of limbs
-(less commonly) flexion/upper and extension/lower
clonic seizure
contraction, relaxation of extremities, hyperventilation
atonic seizure
"Drop attack," a seizure in which the legs suddenly and temporarily collapse, sudden loss of muscle
tone
Clinical manifestations and complications of status epilepticus
back-to-back seizures lasting more than 5 mins or without recovery time, affects young and elderly,
tonic-clonic can result in respiratory failure and death, treat the cause, secure the airway, EEG, CT
Signs and symptoms of hemorrhagic stroke
vomiting and "worst headache of my life" (aneurysm)
Causes of hemorrhagic stroke
intracerebral hemorrhage, cerebral aneurysm, arterovenous malformation (age and HTN are risk
factors)
With Verified Answers
Migraine without Aura
85% of migraines, pulsatile, throbbing, unilateral, can last 4-72 hours, aggravated by physical activity,
can be accompanied by N/V, sensitivity to light, sounds, smells, and visual disturbances
Migraine with Aura
15% of migraines, pulsatile, throbbing, unilateral, aggravated by physical activity, can be accompanied
by N/V, sensitivity to light, sounds, smells, and visual disturbance, develops over 5-20 mins and can
last an hour, usually genetic
Static Migranosis
Migraine lasting longer than 72 hours, need to be admitted for IV pain relief
Cluster Headache
Severe, unilateral, 15 min-3 hour headache. Can have for weeks or months at a time, sxs disappear
then come back. Hereditary.
Tension Headache
Hat-band type pain, usually not debilitating, dull, aching headache
Chronic Daily Headache
15 or more headaches per month, could be due to medication overuse, caffeine, etc.
Non-Pharmalogical measures for migraine treatment
-Control risk factors and triggers-stress, sleep deprivation, alcohol, foods (eg. chocolate, msg, aged
cheese), visual stimuli, estrogen.
-Behavior interventions-stress management, biofeedback, relaxation therapy, cognitive therapy
-Avoid aggravating factors (specific to person)
First line severe headache treatment
Anti-seizure meds, non-narcotics, narcotics, NSAIDS, triptans, ergotamine, midrin
Acute non-responder care for headaches (20-25% don't respond to first line treatment)
Reglan, prophylaxis, beta blockers for prevention
Seizure vs Epilepsy
Epilepsy: chronic state of recurrent seizures
Seizure: temporary disturbance in brain activity causing nerves to fire excessively
Provoked seizures
Fever (common in children), electrolyte imbalances, hypoglycemia, CNS infection or damage,
meningitis, hypoxia, eclampsia, tumors
Partial (focal) seizures w/o impairment of consciousness
, somatosensory disturbances, involuntary motor movement, autonomic nervous system may be
affected (sweating, tachycardia, hyper/hypotension, pupil changes)
Partial (focal) seizures with impairment of consciousness
Occur in temporal lobe, can start here and then move to other areas. Psychomotor symptoms-lip
smacking, petting clothes, eating. Can have feelings of deja vu, fear, hallucinations, commonly
confused with psych disorders. Confusion postictally is common.
Generalized seizures
seizures that involve the entire brain, can all be followed by Todd's paralysis for 24 hours (temporary
paresis, hemianopia, aphasia-speech/understanding). Include tonic-clonic, absence, myoclonic, tonic,
clonic, and atonic seizures
tonic-clonic seizure (grand mal)
generalized seizure in which the patient loses consciousness and has jerking movements of paired
muscle groups, loss of bladder and bowel control
Absence seizures (petit mal)
Occurs during childhood, stares off with little to no tonic-clonic movement, brief unresponsive
episode, MORRIS
myoclonic seizure
quick, repetitive jerks of the face, trunk, or 1 or more extremities
Tonic seizure
-Stiffening & extension of limbs
-(less commonly) flexion/upper and extension/lower
clonic seizure
contraction, relaxation of extremities, hyperventilation
atonic seizure
"Drop attack," a seizure in which the legs suddenly and temporarily collapse, sudden loss of muscle
tone
Clinical manifestations and complications of status epilepticus
back-to-back seizures lasting more than 5 mins or without recovery time, affects young and elderly,
tonic-clonic can result in respiratory failure and death, treat the cause, secure the airway, EEG, CT
Signs and symptoms of hemorrhagic stroke
vomiting and "worst headache of my life" (aneurysm)
Causes of hemorrhagic stroke
intracerebral hemorrhage, cerebral aneurysm, arterovenous malformation (age and HTN are risk
factors)
