Headache, Dementia and Depression: Final Exam

Question 1

Define Headache.

Answer 1

Pain or discomfort in the head is caused by various factors. Described as; throbbing, pounding, painful etc.

Question 2

Is a Headache a Diagnosis?

Answer 2

A headache is ONLY a symptom and the underlying diagnosis must be explored. DO NOT treat without investigating,

Question 3

Define Migraine.

Answer 3

Common chronic headache disorder
Criteria to be considered a migraine:
- Last for more than 15 days per month for 3 months

Question 4

Pathology Sequelae of a Migraine.

Answer 4

Trigeminal nerve irritation, inflammation within meningeal vasculature. (the headache is intense and within the meninges)

Question 5

Signs and Symptoms of a Migraine.

Answer 5

• Prodrome fatigue
• Irritability (pre-migraine)
• Nausea and vomiting
• Intense headache
• Hypersensitivity to stimuli
• Sensory disturbances

Question 6

Migraine Treatment.

Answer 6

• Analgesics: NSAIDS, Tylenol
• Serotonin agonists
• Inhibitory= calming (Meds: Sumatriptan, Zolmitriptan)
• Botox- superficial scalp IM injections (Antiinflammatory actions; decrease neurotransmitter hyperstimulation)
• Caffeine
• Antiemetics (NOT serotonin inhibitors)

Question 7

How does Botox Work for Migraine Treatment?

Answer 7

They decrease the release of acetylcholine, causing a neuromuscular blocking effect.

Question 8

Define Depression.

Answer 8

A common mental disorder that presents with depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration.

Question 9

Pharmaceutical Treatment for Depression.

Answer 9

1. Selective serotonin reuptake inhibitors (SSRIs): 1st line drugs, that increase Serotonin levels
2. ‘Atypical Antidepressants’, SNRIs - increase Serotonin & Norepinephrine, by inhibiting the re-uptake of molecules.
3. Tricyclic antidepressants: Serotonin, norepinephrine, dopamine reuptake inhibitors, resulting in an increase in levels.
4. MAO inhibitors: treat depression by preventing the breakdown of the brain chemicals serotonin, dopamine, and norepinephrine.
5. Non-pharmacological: counselling (CBT)

Question 10

Selective serotonin reuptake inhibitors (SSRIs) Medications.

Answer 10

Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil)

Question 11

‘Atypical Antidepressants’ Medications.

Answer 11

Mirtazapine (Remeron), Bupropion (Wellbutrin)

Question 12

Tricyclic antidepressants Medications.

Answer 12

Imipramine (Impril)

Question 13

Define Dementia.

Answer 13

A deficit in short & long-term memory; is associated with deficits in higher cortical functions such as judgement, or a personality change.

Question 14

Signes and Symptoms of Dementia.

Answer 14

• Memory Loss
• Difficulty COmmunicating
• Difficulty reasoning or problem-solving
• Difficulty planning and organizing
• Inability to complete ADLs

Question 15

Define Alzheimer’s Disease.

Answer 15

a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks.
Progressive loss of neurons and synapses

Question 16

Etiology of Alzheimer’s Disease.

Answer 16

Caused by the accumulation of beta-amyloid deposits. It is formed from the breakdown of a larger protein, called amyloid precursor protein. In the Alzheimer’s brain, abnormal levels of this naturally occurring protein clump together to form plaques that collect between neurons and disrupt cell function.

Question 17

Treatment for Alzheimer’s Disease.

Answer 17

Increase Ach (acetylcholine)
Meds: Cholinesterase inhibitors (decrease Ach breakdown, therefore INCREASE acetylcholine)

Question 18

Define Nicotine Agonists.

Answer 18

A nicotinic agonist is a drug that mimics the action of acetylcholine (ACh)
Activate acetylcholine at nicotinic receptors