NR 603 ADVANCED HEALTH
ASSESSMENT NEUROLOGY
CORE CLINICAL CONTENT
Neurological Assessments
Clinical Management
Pediatric Clinical Findings
Pathophysiology & Diagnostics
high-yield topics exam questions and answers
What are the hallmark characteristics of a tension-type headache? - ANSWER-
Bilateral, band-like pressure or tightness of mild-to-moderate intensity, lasting 30
minutes to 7 days.
What is the first-line acute treatment for tension-type headaches? - ANSWER-
Simple analgesics like NSAIDs (ibuprofen, naproxen) or acetaminophen.
What are the key clinical features of a migraine headache? - ANSWER-Unilateral,
throbbing or pulsatile pain lasting 4-72 hours, accompanied by photophobia,
phonophobia, and nausea.
What is a migraine aura? - ANSWER-Fully reversible focal neurological symptoms
(visual, sensory, or motor) that develop gradually before a migraine.
What is a scintillating scotoma? - ANSWER-A common visual aura characterized by
a flickering zigzag arc that gradually expands.
What are common pharmacologic abortive therapies for migraines? - ANSWER-
Triptans (e.g., sumatriptan) and calcitonin gene-related peptide (CGRP) receptor
antagonists.
What is a primary contraindication for triptan use? - ANSWER-Ischemic heart
disease, history of stroke, uncontrolled hypertension, or basilar/hemiplegic
migraine.
What medications are used for migraine prevention? - ANSWER-Beta-blockers
(propranolol), tricyclic antidepressants (amitriptyline), anticonvulsants
(topiramate), and CGRP monoclonal antibodies.
What are the classic clinical features of a cluster headache? - ANSWER-Severe,
strictly unilateral, periorbital/temporal pain lasting 15-180 minutes, associated with
ipsilateral autonomic symptoms.
What autonomic symptoms accompany cluster headaches? - ANSWER-Ipsilateral
, conjunctival injection, lacrimation, nasal congestion, rhinorrhea, miosis, ptosis, and
eyelid edema.
What is the acute treatment of choice for a cluster headache? - ANSWER-100%
high-flow oxygen via non-rebreather mask and subcutaneous sumatriptan.
What is the transition/preventative therapy used in cluster headaches? - ANSWER-
Verapamil and short-term transitional corticosteroids (e.g., prednisone bridge).
What is medication overuse headache (rebound headache)? - ANSWER-A daily or
near-daily headache caused by the frequent use of acute headache medications
(greater than 2-3 days per week).
What red flag symptoms in a headache evaluation suggest a secondary cause? -
ANSWER-Sudden onset ('thunderclap'), fever, stiff neck, papilledema, focal
neurologic deficits, or new onset after age 50.
What diagnostic imaging is preferred for evaluating a thunderclap headache? -
ANSWER-Non-contrast head CT followed by lumbar puncture if CT is negative to
rule out subarachnoid hemorrhage.
What is temporal arteritis (giant cell arteritis)? - ANSWER-A systemic inflammatory
vasculitis affecting medium and large vessels, presenting with new temporal
headaches, jaw claudication, and visual changes.
What lab tests are elevated in temporal arteritis? - ANSWER-Erythrocyte
sedimentation rate (ESR) and C-reactive protein (CRP).
What is the definitive diagnostic test for temporal arteritis? - ANSWER-Temporal
artery biopsy showing granulomatous inflammation.
What is the classic presentation of essential tremor? - ANSWER-Bilateral postural
and action tremor of the hands, often worse with anxiety or movement and
improved with small amounts of alcohol.
What is the first-line medical treatment for essential tremor? - ANSWER-Non-
selective beta-blockers (e.g., propranolol) and primidone.
How does an essential tremor differ from a Parkinsonian tremor? - ANSWER-
Essential tremor is an action/postural tremor, whereas Parkinson's is typically a
resting 'pill-rolling' tremor.
What is the underlying pathophysiology of Myasthenia Gravis? - ANSWER-
Autoimmune destruction of postsynaptic nicotinic acetylcholine receptors at the
neuromuscular junction.
What is the hallmark clinical feature of Myasthenia Gravis? - ANSWER-Fluctuating
skeletal muscle weakness that worsens with repetitive use and improves with rest.
ASSESSMENT NEUROLOGY
CORE CLINICAL CONTENT
Neurological Assessments
Clinical Management
Pediatric Clinical Findings
Pathophysiology & Diagnostics
high-yield topics exam questions and answers
What are the hallmark characteristics of a tension-type headache? - ANSWER-
Bilateral, band-like pressure or tightness of mild-to-moderate intensity, lasting 30
minutes to 7 days.
What is the first-line acute treatment for tension-type headaches? - ANSWER-
Simple analgesics like NSAIDs (ibuprofen, naproxen) or acetaminophen.
What are the key clinical features of a migraine headache? - ANSWER-Unilateral,
throbbing or pulsatile pain lasting 4-72 hours, accompanied by photophobia,
phonophobia, and nausea.
What is a migraine aura? - ANSWER-Fully reversible focal neurological symptoms
(visual, sensory, or motor) that develop gradually before a migraine.
What is a scintillating scotoma? - ANSWER-A common visual aura characterized by
a flickering zigzag arc that gradually expands.
What are common pharmacologic abortive therapies for migraines? - ANSWER-
Triptans (e.g., sumatriptan) and calcitonin gene-related peptide (CGRP) receptor
antagonists.
What is a primary contraindication for triptan use? - ANSWER-Ischemic heart
disease, history of stroke, uncontrolled hypertension, or basilar/hemiplegic
migraine.
What medications are used for migraine prevention? - ANSWER-Beta-blockers
(propranolol), tricyclic antidepressants (amitriptyline), anticonvulsants
(topiramate), and CGRP monoclonal antibodies.
What are the classic clinical features of a cluster headache? - ANSWER-Severe,
strictly unilateral, periorbital/temporal pain lasting 15-180 minutes, associated with
ipsilateral autonomic symptoms.
What autonomic symptoms accompany cluster headaches? - ANSWER-Ipsilateral
, conjunctival injection, lacrimation, nasal congestion, rhinorrhea, miosis, ptosis, and
eyelid edema.
What is the acute treatment of choice for a cluster headache? - ANSWER-100%
high-flow oxygen via non-rebreather mask and subcutaneous sumatriptan.
What is the transition/preventative therapy used in cluster headaches? - ANSWER-
Verapamil and short-term transitional corticosteroids (e.g., prednisone bridge).
What is medication overuse headache (rebound headache)? - ANSWER-A daily or
near-daily headache caused by the frequent use of acute headache medications
(greater than 2-3 days per week).
What red flag symptoms in a headache evaluation suggest a secondary cause? -
ANSWER-Sudden onset ('thunderclap'), fever, stiff neck, papilledema, focal
neurologic deficits, or new onset after age 50.
What diagnostic imaging is preferred for evaluating a thunderclap headache? -
ANSWER-Non-contrast head CT followed by lumbar puncture if CT is negative to
rule out subarachnoid hemorrhage.
What is temporal arteritis (giant cell arteritis)? - ANSWER-A systemic inflammatory
vasculitis affecting medium and large vessels, presenting with new temporal
headaches, jaw claudication, and visual changes.
What lab tests are elevated in temporal arteritis? - ANSWER-Erythrocyte
sedimentation rate (ESR) and C-reactive protein (CRP).
What is the definitive diagnostic test for temporal arteritis? - ANSWER-Temporal
artery biopsy showing granulomatous inflammation.
What is the classic presentation of essential tremor? - ANSWER-Bilateral postural
and action tremor of the hands, often worse with anxiety or movement and
improved with small amounts of alcohol.
What is the first-line medical treatment for essential tremor? - ANSWER-Non-
selective beta-blockers (e.g., propranolol) and primidone.
How does an essential tremor differ from a Parkinsonian tremor? - ANSWER-
Essential tremor is an action/postural tremor, whereas Parkinson's is typically a
resting 'pill-rolling' tremor.
What is the underlying pathophysiology of Myasthenia Gravis? - ANSWER-
Autoimmune destruction of postsynaptic nicotinic acetylcholine receptors at the
neuromuscular junction.
What is the hallmark clinical feature of Myasthenia Gravis? - ANSWER-Fluctuating
skeletal muscle weakness that worsens with repetitive use and improves with rest.
