Review Note

Last Update: 02/28/2024 08:31 PM

Current Deck: Step 2::Mehlman::Mehlman HY 4

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Text
29M+ lancinating/stabbing pain in cheek lasting several seonds + happens spontaneously; Q asks location of problem:

{{c1::Pons}}
Extra
unusual answer, since trigeminal neuralgia is a peripheral mechanism, but CN V comes from pons;
answer can also be "microvascular compression of CN V"; no acute Tx since Sx subside so quickly; prophylaxis is carbamazepine

Do not confuse trigeminal neuralgia of the V1 distribution with cluster headache; the latter
will occur usually during sleep and will last up to half hour; details such as lacrimation and
rhinorrhea are HY but too easy and often omitted from Qs; Q can mention pupillary changes
during cluster headache; Tx = 100% oxygen; prophylaxis is verapamil (not propranolol).


Migraine prophylaxis on USMLE = propranolol (sometimes just written as beta blockade); Tx
is NSAIDs followed by triptans (serotonin receptor agonists).
Lecture Notes
Missed Questions
Pathoma
Boards and Beyond
First Aid
Sketchy
Physeo
Additional Resources

Current Tags:

#Mehlman::IM

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