01 CARDIOVASCULAR 01.08 03 GASTROINTESTINAL MEDICINE 04 NEUROLOGY 04.13
• Deep vein thrombosis (DVT) & GENERAL SURGERY • Spinal disorders
01.01 • Pulmonary embolism (PE) 04.01 Headaches - Brown-sequard syndrome
• Acute coronary syndrome • Infective endocarditis 03.01 - Subacute combined degeneration
- STEMI, NSTEMI, unstable angina • Pericarditis • Gallbladder disorders 04.02 Neurodegenerative disorders - Friedrich's ataxia
- ECG cardiac territories • Constructive pericarditis - Acute cholecystitis • Dementias • Delirium - Anterior spinal artery occlusion
• Hypertension - Ascending cholangitis - Syringomyelia
- Antihypertensives 01.09 - PSC & PBC 04.03 Neurodegenerative – movement - Tabes dorsalis
• Cardiac tamponade • Liver cancers – hepatocellular disorders, incl Parkinson's, • Neurofibromatosis
01.02 • Antihypertensives (continued) carcinoma & cholangiocarcinoma Huntington's and motor neuron disease • Tuberous sclerosis
• Ischaemic heart disease • Other drugs (adenosine, amiodarone,
• Atrial fibrillation anti-platelets) 03.02 04.04 Infections 04.14
• Adult life support • DLVA rules on cardiovascular disorders • Alcohol-related liver disease • Bacterial & viral meningitis • Restless legs syndrome
• Wilson’s disease • Encephalitis • Abnormal involuntary movements
01.03 01.10 Vascular surgery • Haemochromatosis • Brain & spinal epidural abscesses • DLVA rules for neurological disorders
• Ventricular fibrillation • Peripheral arterial disease • Aphasia DDx
• Ventricular tachycardia • Aortic aneurysm 03.03 04.05 Infections • Wernicke's encephalopathy
• Bradycardia: peri-arrest • Aortic dissection • Hepatitis A, B, C, E • Specific infxns: toxoplasmosis, primary • Charcot-Marie-Tooth syndrome
© quackquackmed.com
• Tachycardia: peri-arrest • Varicose veins • Autoimmune hepatitis CNS lymphoma, cryptococcosis, PML
• Pacemakers • Lower leg ulcers • Non-alcoholic fatty liver disease • Glasgow Coma Scale (GCS)
05 OPHTHALMOLOGY
• Cardiac enzymes • Ankle-brachial pressure index (ABPI) • CSF interpretation table
03.04
05.01 Blindness
01.04 • Paracetamol overdose 04.06 Epilepsy / seizures
• Retinal detachment
• Electrocardiogram (ECG) 02 RESPIRATORY • Disorders of the pancreas • Seizures, incl status epilepticus
• Retinal artery & vein occlusion
• Arrhythmias, including Wolff-Parkinson- - Acute & chronic pancreatitis • Psychogenic non-epileptic seizures • Retinal migraine
White syndrome, Wellen's syndrome, 02.01 - Pancreatic cancer • Anticonvulsants / antiepileptics • Giant cell arteritis • Optic neuritis
junctional escape rhythm • Asthma • COPD - Neuroendocrine tumours
• Papilloedema
• Respiratory failure • Small bowel bacterial overgrowth 04.07
• Vitreous haemorrhage
01.05 syndrome • Syncope • DDx – loss of colour vision
• Long QT syndrome 02.02 • Brain tumours • DDx – blurred vision
• Short QT syndrome • Lung cancers 03.05 • IBD – Crohn's & UC • Brain lesions localisation (smx)
• Brugada syndrome • Mesothelioma • Coeliac disease 05.02 Red eye
• Atrial flutter • Bronchiectasis 04.08 Strokes • Glaucoma – closed-angle
• Shock (÷ different types) • Idiopathic pulmonary fibrosis 03.06 • TIA & ischaemic stroke
• Anterior uveitis
• Appendicitis - Classifications by arteries, smx
• Episcleritis & scleritis
01.06 02.03 • Small & large bowel obstructions • Haemorrhagic stroke • Keratitis
• Valve disorders – mitral stenosis, mitral • Pneumonia – CAP + HAP • Hernias
• Common meds in ophthalmology
regurg, aortic stenosis, aortic regurg - In immunocompromised patients 04.09 Brain bleeds
• Conjunctivitis (on 05.03)
• Murmurs (DDx) • Tuberculosis 03.07 • Subarachnoid haemorrhage
• Rheumatic fever • Anal fissures & fistulae, haemorrhoids • Subdural & extradural haemorrhage 05.03 External eye problems
• Prosthetic heart valves 02.04 • Colorectal cancer • Cerebral aneurysm • Blepharitis • Blepharospasm
• Pulses (different types, eg pulsus • Sarcoidosis
• Ectropion & entropion
paradoxus) • Pneumothorax 03.08 04.10 Weakness DDx
• Pingucela • Hordeolum / stye
• Heart sounds • Pleural effusions • GORD, gastritis, peptic ulcer disease
• Ophthalmic shingles
• Cystic fibrosis • Oesophageal conditions 04.11 Neuroinflammatory disorders
01.07 • Oxygen therapy • ERCP, TIPS • Multiple sclerosis
05.04 Age-related conditions
• Hypertrophic obstructive • Guillain Barre syndrome • Glaucoma – open-angle
cardiomyopathy (HoCM / HCM) 03.09 – Upper & lower GI bleeding • Chronic inflammatory demyelinating • Age-related macular degeneration
• Arrhythmogenic right ventricular (poly)neuropathy
• Cataracts
cardiomyopathy (ARVC) 03.10 • Myasthenia gravis
• Diabetic neuropathy
• Dilated cardiomyopathy • Irritable bowel syndrome (IBS)
• Orbital & periorbital celluitis
• Chronic heart failure • Diverticular disease 04.12
• Ischaemic bowel disease • CT head – indications
05.05 • Thyroid eye disease
• Abdominal pain DDx • Head injury
• Strabismus / squints
• Intracranial pressure – ↑ & ↓ • Pupil problems
3a – Primer on anaesthetics
• Tropical eye diseases
• General anaesthesia & airway adjuncts
• Regiona/local anaesthesia
• Post-op nausea & vomiting
, Migraine Cluster headache Trigeminal neuralgia Medication overuse HA Other causes of headaches
Acute, single episodes
D: chronic, episodic neurological disorder
characterised chiefly by severe
D: a trigeminal autonomic cephal-algia
causing HAs that occur in a cluster of
D: facial pain syndrome in the distribution
of ≥1 divisions of the trigeminal nerve
D: chronic HA 2/2 overuse of analgesics;
≥15d/mo. Common. •🚩 Subarachnoid haemorrhage
headaches ± aura weeks around once a year (CN V) ↳ occipital location
↳ "thunderclap" - sudden onset
Chronic = 8d/mo for ≥3mo
R: ↑age, multiple sclerosis (20x), ?F>M
A/P: not fully understood. ? overuse of ↳ "worse headache of my life"
R: M>F (3:1), FHx, head injury, smoking, analgesics leads to ↓sensitivity of
receptors to analgesia → when analgesic
•🚩 Glaucoma (acute, closed-angle)
R: FHx, F>M (~3:1), young to middle alcohol use (can trigger) (3:2), ?HTN
↳ severe pain; can be ocular or
age, obesity (BMI>30), stress, sleep is withdrawn, paradoxical pain ("rebound generalised HA
disorder A: unknown A: • focal compression of CN V root effect") ↳ + ↓visual acuity, hard red eye, semi-
P: trigeminal distribution, ipsilateral by aberrant vascular loop dilated non-reacting pupil
🚩
© quackquackmed.com
A: uncertain; ?hyperexcitable brain. cranial autonomic smx, occuring a few • idiopathic / other causes Dx: • pre-existing HA disorder resulting in • Mengitits / encephalitis
Strong genetic component weeks a year P: focal demyelination → conduction the need for analgesia ↳ non-specific smx
P: neurogenic inflammation of dysfunction → pain • HA ≥15d/mo • Head injury
trigeminal sensory neurons → S/smx: • HA 15min to 2h • regular analgesic overuse for >3mo – • Sinusitis
people taking triptans or opioids at ↑risk ↳ a/w rhinorrhea, allergic type smx
vasodilation of blood vessels → HA • Clusters typically ~4-12w S/smx: • brief (seconds) - sudden
• Intense, sharp stabbing pain around • not better accounted for by other HA • Tropical illness, eg malaria
• Aura: neuronal dysfunction onset and sudden cessation
one eye (described as the one of the syndromes
• electric shock-like pain
worst kinds of pain) Chronic
S/smx: • HA 4-72h • limited to distribution of CN V
• a/w lacrimation, redness, lid swelling Mx: • if pt is on paracetamol, NSAID • Idiopathic intracranial hypertension
• Unilateral location • triggered by any movement / sensation
• ± miosis, ptosis to the CN V distribution, eg touching the or triptan, withdraw abruptly - R: obesity, F>M, pregnancy, drugs
• Pulsatile quality
• Mod-severe pain
• Pt is often restless during attacks (as face, shaving, brushing teeth, etc ↳ warn pt that HA will get worse then (COCP, steroids, tetracyclines,
opposed to migraines where pt often better; persist! retinoids, lithium)
• if pt is on opioids, gradual ↓
• Aggravation by or causing avoidance - Smx: + blurred vision, papilloedema,
just wants to lie down)
of usual activity Ix: clinical Dx; r/o red flags • Withdrawal smx: NV, hypotension,↑HR, enlarged blind spot ± CN VI palsy
• ± NV, photophobia, phonophobia
restlessness, anxiety, sleep (see section ICP →04.12)
• ± in F, may be a/w menses
• ± Aura (25%): visual smx (eg scotoma)
Ix: MRI head with gadolinium
Mx: ☝🏻 carbamazepine disturbance, etc – persist!! • Chronically raised ICP
• Paget's disease of the bone
• if no response, ref to neurology
Mx: • ref to neurology - 2/2 mechanical compression or
Ix: clinical Dx; r/o red flag smx • 100% oxygen & subcut triptan ↓blood flow to neural tissue
↳ 80% and 75% respond w/in 15min - occipital HA, worse on coughing
for each tx respectively Tension headache aka tension-type HA Temporal arteritis • Psychological
Mx of acute migraines • Prophylaxis: verapamil for more info, see Giant Cell Arteritis under
• sumatripan + NSAID/paracetamol ± tapering dose of prednisolone D: HA characterised by generalised Rheumatology; this section only covers headache
↳ in 12-17yo, consider nasal
• ✌🏻
triptan instead of PO
non-PO metoclopramide or
distribution like a "tight band around the
head" D: aka giant cell arteritis
Vasculitis affecting medium and large
🚩 Headache red flags 🚩
prochlorperazine, consider non-PO arteries – in this case, temporal artery "SNOOP4"
Trigeminal autonomic R: mental tension / stress, fatigue,
NSAID or triptan • Systemic smx, incl fever
cephalalgia missing meals, dehydration
R: >50-60yo, F>M, ?FHx • Neoplasm in PMH, FHx
Prophylaxis of migraines
• Neurologic deficit or ∆
• propranolol D: group of primary HA disorders A: unknown. ? muscle tension • Onset – sudden/abrupt
• topiramate (NOT in women of child- characterized by P: release and activation of inflam-matory S/smx: • HA occurs in 85% of pts
• Older age >50yo
bearing age; teratogenic) • unilateral head pain agents → pain with GCA, with a tender, palpable
• Pattern ∆ or recent onset
• amitriptyline • a/w generally prominent ipsilateral temporal artery
• Positional HA
• for F with predictable menses-related cranial autonomic features • Rapid onset, Hx of <1mo, unilateral
S/smx: • "tight band around head" • Precipitated by sneezing, coughing,
migraines, frovatriptan or zolmitriptan • can coexist with migraine HA, but • Jaw claudication in 65%
may be given Include • cluster HA exercise
does not have features of migraine • ± ocular complications
↳ ± mefenamic acid, caffeine • paroxysmal hemicrania • Papilloedema
• Progressive HA + atypical smx
☝🏻
• in pregnancy, paracetamol + NSAIDs • short-lasting unilateral neuralgiform
headache attacks with conjunctival Mx: paracetamol, NSAIDs, aspirin Ix: ↑ESR. Temporal artery biopsy to • Pregnancy or puerperium
(2nd line); avoid aspirin and opioids
injection and tearing (SUNCT) • Avoid known triggers confirm (may require >1 biopsy due to • Painful eye with autonomic features
• Migraines with aura are an absolute
• short-lasting unilateral neuralgiform skip lesions) • Post-traumatic onset
CI against COCP ∵ ↑↑risk of stroke
headache attacks with cranial • Pathology of immune system eg HIV
• HRT might worsen migraines
autonomic symptoms (SUNA) • Painkiller overuse or new drug at
onset of HA
04.01 Neuro – Headaches
• Deep vein thrombosis (DVT) & GENERAL SURGERY • Spinal disorders
01.01 • Pulmonary embolism (PE) 04.01 Headaches - Brown-sequard syndrome
• Acute coronary syndrome • Infective endocarditis 03.01 - Subacute combined degeneration
- STEMI, NSTEMI, unstable angina • Pericarditis • Gallbladder disorders 04.02 Neurodegenerative disorders - Friedrich's ataxia
- ECG cardiac territories • Constructive pericarditis - Acute cholecystitis • Dementias • Delirium - Anterior spinal artery occlusion
• Hypertension - Ascending cholangitis - Syringomyelia
- Antihypertensives 01.09 - PSC & PBC 04.03 Neurodegenerative – movement - Tabes dorsalis
• Cardiac tamponade • Liver cancers – hepatocellular disorders, incl Parkinson's, • Neurofibromatosis
01.02 • Antihypertensives (continued) carcinoma & cholangiocarcinoma Huntington's and motor neuron disease • Tuberous sclerosis
• Ischaemic heart disease • Other drugs (adenosine, amiodarone,
• Atrial fibrillation anti-platelets) 03.02 04.04 Infections 04.14
• Adult life support • DLVA rules on cardiovascular disorders • Alcohol-related liver disease • Bacterial & viral meningitis • Restless legs syndrome
• Wilson’s disease • Encephalitis • Abnormal involuntary movements
01.03 01.10 Vascular surgery • Haemochromatosis • Brain & spinal epidural abscesses • DLVA rules for neurological disorders
• Ventricular fibrillation • Peripheral arterial disease • Aphasia DDx
• Ventricular tachycardia • Aortic aneurysm 03.03 04.05 Infections • Wernicke's encephalopathy
• Bradycardia: peri-arrest • Aortic dissection • Hepatitis A, B, C, E • Specific infxns: toxoplasmosis, primary • Charcot-Marie-Tooth syndrome
© quackquackmed.com
• Tachycardia: peri-arrest • Varicose veins • Autoimmune hepatitis CNS lymphoma, cryptococcosis, PML
• Pacemakers • Lower leg ulcers • Non-alcoholic fatty liver disease • Glasgow Coma Scale (GCS)
05 OPHTHALMOLOGY
• Cardiac enzymes • Ankle-brachial pressure index (ABPI) • CSF interpretation table
03.04
05.01 Blindness
01.04 • Paracetamol overdose 04.06 Epilepsy / seizures
• Retinal detachment
• Electrocardiogram (ECG) 02 RESPIRATORY • Disorders of the pancreas • Seizures, incl status epilepticus
• Retinal artery & vein occlusion
• Arrhythmias, including Wolff-Parkinson- - Acute & chronic pancreatitis • Psychogenic non-epileptic seizures • Retinal migraine
White syndrome, Wellen's syndrome, 02.01 - Pancreatic cancer • Anticonvulsants / antiepileptics • Giant cell arteritis • Optic neuritis
junctional escape rhythm • Asthma • COPD - Neuroendocrine tumours
• Papilloedema
• Respiratory failure • Small bowel bacterial overgrowth 04.07
• Vitreous haemorrhage
01.05 syndrome • Syncope • DDx – loss of colour vision
• Long QT syndrome 02.02 • Brain tumours • DDx – blurred vision
• Short QT syndrome • Lung cancers 03.05 • IBD – Crohn's & UC • Brain lesions localisation (smx)
• Brugada syndrome • Mesothelioma • Coeliac disease 05.02 Red eye
• Atrial flutter • Bronchiectasis 04.08 Strokes • Glaucoma – closed-angle
• Shock (÷ different types) • Idiopathic pulmonary fibrosis 03.06 • TIA & ischaemic stroke
• Anterior uveitis
• Appendicitis - Classifications by arteries, smx
• Episcleritis & scleritis
01.06 02.03 • Small & large bowel obstructions • Haemorrhagic stroke • Keratitis
• Valve disorders – mitral stenosis, mitral • Pneumonia – CAP + HAP • Hernias
• Common meds in ophthalmology
regurg, aortic stenosis, aortic regurg - In immunocompromised patients 04.09 Brain bleeds
• Conjunctivitis (on 05.03)
• Murmurs (DDx) • Tuberculosis 03.07 • Subarachnoid haemorrhage
• Rheumatic fever • Anal fissures & fistulae, haemorrhoids • Subdural & extradural haemorrhage 05.03 External eye problems
• Prosthetic heart valves 02.04 • Colorectal cancer • Cerebral aneurysm • Blepharitis • Blepharospasm
• Pulses (different types, eg pulsus • Sarcoidosis
• Ectropion & entropion
paradoxus) • Pneumothorax 03.08 04.10 Weakness DDx
• Pingucela • Hordeolum / stye
• Heart sounds • Pleural effusions • GORD, gastritis, peptic ulcer disease
• Ophthalmic shingles
• Cystic fibrosis • Oesophageal conditions 04.11 Neuroinflammatory disorders
01.07 • Oxygen therapy • ERCP, TIPS • Multiple sclerosis
05.04 Age-related conditions
• Hypertrophic obstructive • Guillain Barre syndrome • Glaucoma – open-angle
cardiomyopathy (HoCM / HCM) 03.09 – Upper & lower GI bleeding • Chronic inflammatory demyelinating • Age-related macular degeneration
• Arrhythmogenic right ventricular (poly)neuropathy
• Cataracts
cardiomyopathy (ARVC) 03.10 • Myasthenia gravis
• Diabetic neuropathy
• Dilated cardiomyopathy • Irritable bowel syndrome (IBS)
• Orbital & periorbital celluitis
• Chronic heart failure • Diverticular disease 04.12
• Ischaemic bowel disease • CT head – indications
05.05 • Thyroid eye disease
• Abdominal pain DDx • Head injury
• Strabismus / squints
• Intracranial pressure – ↑ & ↓ • Pupil problems
3a – Primer on anaesthetics
• Tropical eye diseases
• General anaesthesia & airway adjuncts
• Regiona/local anaesthesia
• Post-op nausea & vomiting
, Migraine Cluster headache Trigeminal neuralgia Medication overuse HA Other causes of headaches
Acute, single episodes
D: chronic, episodic neurological disorder
characterised chiefly by severe
D: a trigeminal autonomic cephal-algia
causing HAs that occur in a cluster of
D: facial pain syndrome in the distribution
of ≥1 divisions of the trigeminal nerve
D: chronic HA 2/2 overuse of analgesics;
≥15d/mo. Common. •🚩 Subarachnoid haemorrhage
headaches ± aura weeks around once a year (CN V) ↳ occipital location
↳ "thunderclap" - sudden onset
Chronic = 8d/mo for ≥3mo
R: ↑age, multiple sclerosis (20x), ?F>M
A/P: not fully understood. ? overuse of ↳ "worse headache of my life"
R: M>F (3:1), FHx, head injury, smoking, analgesics leads to ↓sensitivity of
receptors to analgesia → when analgesic
•🚩 Glaucoma (acute, closed-angle)
R: FHx, F>M (~3:1), young to middle alcohol use (can trigger) (3:2), ?HTN
↳ severe pain; can be ocular or
age, obesity (BMI>30), stress, sleep is withdrawn, paradoxical pain ("rebound generalised HA
disorder A: unknown A: • focal compression of CN V root effect") ↳ + ↓visual acuity, hard red eye, semi-
P: trigeminal distribution, ipsilateral by aberrant vascular loop dilated non-reacting pupil
🚩
© quackquackmed.com
A: uncertain; ?hyperexcitable brain. cranial autonomic smx, occuring a few • idiopathic / other causes Dx: • pre-existing HA disorder resulting in • Mengitits / encephalitis
Strong genetic component weeks a year P: focal demyelination → conduction the need for analgesia ↳ non-specific smx
P: neurogenic inflammation of dysfunction → pain • HA ≥15d/mo • Head injury
trigeminal sensory neurons → S/smx: • HA 15min to 2h • regular analgesic overuse for >3mo – • Sinusitis
people taking triptans or opioids at ↑risk ↳ a/w rhinorrhea, allergic type smx
vasodilation of blood vessels → HA • Clusters typically ~4-12w S/smx: • brief (seconds) - sudden
• Intense, sharp stabbing pain around • not better accounted for by other HA • Tropical illness, eg malaria
• Aura: neuronal dysfunction onset and sudden cessation
one eye (described as the one of the syndromes
• electric shock-like pain
worst kinds of pain) Chronic
S/smx: • HA 4-72h • limited to distribution of CN V
• a/w lacrimation, redness, lid swelling Mx: • if pt is on paracetamol, NSAID • Idiopathic intracranial hypertension
• Unilateral location • triggered by any movement / sensation
• ± miosis, ptosis to the CN V distribution, eg touching the or triptan, withdraw abruptly - R: obesity, F>M, pregnancy, drugs
• Pulsatile quality
• Mod-severe pain
• Pt is often restless during attacks (as face, shaving, brushing teeth, etc ↳ warn pt that HA will get worse then (COCP, steroids, tetracyclines,
opposed to migraines where pt often better; persist! retinoids, lithium)
• if pt is on opioids, gradual ↓
• Aggravation by or causing avoidance - Smx: + blurred vision, papilloedema,
just wants to lie down)
of usual activity Ix: clinical Dx; r/o red flags • Withdrawal smx: NV, hypotension,↑HR, enlarged blind spot ± CN VI palsy
• ± NV, photophobia, phonophobia
restlessness, anxiety, sleep (see section ICP →04.12)
• ± in F, may be a/w menses
• ± Aura (25%): visual smx (eg scotoma)
Ix: MRI head with gadolinium
Mx: ☝🏻 carbamazepine disturbance, etc – persist!! • Chronically raised ICP
• Paget's disease of the bone
• if no response, ref to neurology
Mx: • ref to neurology - 2/2 mechanical compression or
Ix: clinical Dx; r/o red flag smx • 100% oxygen & subcut triptan ↓blood flow to neural tissue
↳ 80% and 75% respond w/in 15min - occipital HA, worse on coughing
for each tx respectively Tension headache aka tension-type HA Temporal arteritis • Psychological
Mx of acute migraines • Prophylaxis: verapamil for more info, see Giant Cell Arteritis under
• sumatripan + NSAID/paracetamol ± tapering dose of prednisolone D: HA characterised by generalised Rheumatology; this section only covers headache
↳ in 12-17yo, consider nasal
• ✌🏻
triptan instead of PO
non-PO metoclopramide or
distribution like a "tight band around the
head" D: aka giant cell arteritis
Vasculitis affecting medium and large
🚩 Headache red flags 🚩
prochlorperazine, consider non-PO arteries – in this case, temporal artery "SNOOP4"
Trigeminal autonomic R: mental tension / stress, fatigue,
NSAID or triptan • Systemic smx, incl fever
cephalalgia missing meals, dehydration
R: >50-60yo, F>M, ?FHx • Neoplasm in PMH, FHx
Prophylaxis of migraines
• Neurologic deficit or ∆
• propranolol D: group of primary HA disorders A: unknown. ? muscle tension • Onset – sudden/abrupt
• topiramate (NOT in women of child- characterized by P: release and activation of inflam-matory S/smx: • HA occurs in 85% of pts
• Older age >50yo
bearing age; teratogenic) • unilateral head pain agents → pain with GCA, with a tender, palpable
• Pattern ∆ or recent onset
• amitriptyline • a/w generally prominent ipsilateral temporal artery
• Positional HA
• for F with predictable menses-related cranial autonomic features • Rapid onset, Hx of <1mo, unilateral
S/smx: • "tight band around head" • Precipitated by sneezing, coughing,
migraines, frovatriptan or zolmitriptan • can coexist with migraine HA, but • Jaw claudication in 65%
may be given Include • cluster HA exercise
does not have features of migraine • ± ocular complications
↳ ± mefenamic acid, caffeine • paroxysmal hemicrania • Papilloedema
• Progressive HA + atypical smx
☝🏻
• in pregnancy, paracetamol + NSAIDs • short-lasting unilateral neuralgiform
headache attacks with conjunctival Mx: paracetamol, NSAIDs, aspirin Ix: ↑ESR. Temporal artery biopsy to • Pregnancy or puerperium
(2nd line); avoid aspirin and opioids
injection and tearing (SUNCT) • Avoid known triggers confirm (may require >1 biopsy due to • Painful eye with autonomic features
• Migraines with aura are an absolute
• short-lasting unilateral neuralgiform skip lesions) • Post-traumatic onset
CI against COCP ∵ ↑↑risk of stroke
headache attacks with cranial • Pathology of immune system eg HIV
• HRT might worsen migraines
autonomic symptoms (SUNA) • Painkiller overuse or new drug at
onset of HA
04.01 Neuro – Headaches
