CMN 568 - Unit 5 with questions and
correct answers 2024
Diminution of headache in response to typical migraine therapies (e.g. seratonin
receptor antagonists or ketorolac) does not rule out _________________ as underlying
cause? - Correct AnswersSubarachnoid hemorrhage or meningitis
Mcphee p 39
IMMEDIATE TREATMENT: Vascular events - Correct Answers+ Intracranial
hemorrhage
+ Thrombosis
+ Cavernous sinus thrombosis
+ Vasculitis
+ Malignant hypertension
+ Arterial dissection
+ Aneurysm
McPhee p 39
IMMEDIATE TREATMENT: Infections - Correct Answers+ Abscess
+ Encephalitis
+ Meningitis
Mc Phee p 39
Causes of headache that require IMMEDIATE TREATMENT - Correct Answers+
Vascular events
+ Infections
+ Intracranial masses
+ Preeclampsia
+ Carbon monoxide poisioning
McPhee p 39
"Thunderclap headache" is the classic presentation of what condition? - Correct
AnswersSubarachnoid hemorrhage! Should precipitate IMMEDIATE workup!
McPhee p 39
New headache in a patient > ________________ years or with ___________________
(condition) should warrant IMMEDIATE neuroimaging. - Correct Answers+ > 50years
+ HIV infection
McPhee p 39
,Headache patients with hx of hypertension (esp uncontrolled htn) should be examined
for other features of WHAT? - Correct AnswersMalignant hypertension
McPhee p 39
Headache associated with pregnancy? - Correct AnswersPreeclampsia
McPhee p 39
Episodic headache associated with triad of hypertension, heart palpitations and sweats
is suggestive of __________________. - Correct AnswersPheochromocytoma
McPhee p 39
Symptoms for diagnosis or ruling out migraine in the absence of "classic" presentation
(e.g. scintillating scotomoa, unilateral ha, photophobia and n/v)? - Correct
AnswersSymtoms: Nausea, photophobia, phonophobia and exacerbation with physical
activtiy
THREE OR MORE = MIGRAINE
< THREE = r/o MIGRAINE
McPhee p 39
Critical components of physical exam for complaint of HA? - Correct Answers+ Vital
signs
+ Complete neuro exam
+ Vision testing (with funduscopic exam)
McPhee p 40
Kernig and Brudzinski signs are indicative of what? - Correct AnswersMeningeal
irritation
McPhee p 40
Scalp and temporal artery tenderness should be performed on pts with HA who are >
______________ years. - Correct Answers> 60
McPhee p 40
Components of visual exam for pt presenting with HA? - Correct Answers+ Visual acuity
(Snellen)
+ Ocular gaze (Motor test - 9 positions)
+ Visual fields (Cover test - central/periph vision)
,+ Pupillary defects (Size, dilation)
+ Optic disks
+ Retinal vein pulsations
McPhee p 40
Pt with HA and *diminished visual acuity* suggests.... - Correct Answers+ Glaucoma
+ Temporal arteritis
+ Optic neuritis
McPhee p 40
Pt with HA and *ophthalmoplegia or visual field defects* suggests.... - Correct Answers+
Venous sinus thrombosis
+ Tumor
+ Aneurysm
McPhee p 40
Pt with HA and *hypertension, "cotton wool spots", flame hemorrhages and disk
swelling* suggests.... - Correct Answers+ Acute severe hypertensive retinopathy
McPhee p 40
Pt with HA and *ipsilateral ptosis and miosis* suggests.... - Correct AnswersHorner
syndrome AND/OR carotid artery dissection
McPhee p 40
Pt with HA and *papilledema or absent retinal venous pulsations* suggests.... - Correct
Answers↑ ICP
+ Follow with neuroimaging prior to performing lumbar puncture
McPhee p 40
ANY abnormality on neuro exam (esp mental status) of pt with HA warrants.... - Correct
Answers+ EMERGENT neuroimaging
McPhee p 40
Ottawa criteria for evaluation of pts presenting with acute non-traumatic headache for
signs of subarachnoid hemorrhage - Correct Answers+ ≥ 40 years of age
+ Neck pain/stiffness
+ Witnessed loss of consciousness
+ Onset during exertion
+ Thunderclap headache
, + Limited neck flexion on examination
McPhee p 41
What kind of early treatment of diagnosed migraine or migraine-like headache can abort
or provide significant relief of symptoms? - Correct Answers+ NSAIDs (e.g. ketorolac)
+ Triptans
McPhee p 41
What types of headaches may respond well to high-flow O2 therapy? - Correct
AnswersALL types
McPhee p 41
What types of headaches should be referred? - Correct Answers+ Frequent migraines
not responsive to std tx
+ Migraines with atypical features
+ Chronic daily ha r/t medication overuse
McPhee p 41
Primary headache syndromes? - Correct Answers+ Migraine
+ Tension-type headache
+ Cluster headache
McPhee p 986
Secondary causes of headache? - Correct AnswersSome examples:
+ Intracranial lesions
+ Head injury
+ Cervical spondylosis
+ Dental/ocular disease
+ TMJ dysfunction
+ Sinusitis
+ Hypertension
+ Depression
McPhee p 986
Common age of onset of migraines? - Correct AnswersAdolescence or early adult life
McPhee p 986
Symptoms of migrainous headaches - Correct Answers+ Usually lateral, can be
generalized
correct answers 2024
Diminution of headache in response to typical migraine therapies (e.g. seratonin
receptor antagonists or ketorolac) does not rule out _________________ as underlying
cause? - Correct AnswersSubarachnoid hemorrhage or meningitis
Mcphee p 39
IMMEDIATE TREATMENT: Vascular events - Correct Answers+ Intracranial
hemorrhage
+ Thrombosis
+ Cavernous sinus thrombosis
+ Vasculitis
+ Malignant hypertension
+ Arterial dissection
+ Aneurysm
McPhee p 39
IMMEDIATE TREATMENT: Infections - Correct Answers+ Abscess
+ Encephalitis
+ Meningitis
Mc Phee p 39
Causes of headache that require IMMEDIATE TREATMENT - Correct Answers+
Vascular events
+ Infections
+ Intracranial masses
+ Preeclampsia
+ Carbon monoxide poisioning
McPhee p 39
"Thunderclap headache" is the classic presentation of what condition? - Correct
AnswersSubarachnoid hemorrhage! Should precipitate IMMEDIATE workup!
McPhee p 39
New headache in a patient > ________________ years or with ___________________
(condition) should warrant IMMEDIATE neuroimaging. - Correct Answers+ > 50years
+ HIV infection
McPhee p 39
,Headache patients with hx of hypertension (esp uncontrolled htn) should be examined
for other features of WHAT? - Correct AnswersMalignant hypertension
McPhee p 39
Headache associated with pregnancy? - Correct AnswersPreeclampsia
McPhee p 39
Episodic headache associated with triad of hypertension, heart palpitations and sweats
is suggestive of __________________. - Correct AnswersPheochromocytoma
McPhee p 39
Symptoms for diagnosis or ruling out migraine in the absence of "classic" presentation
(e.g. scintillating scotomoa, unilateral ha, photophobia and n/v)? - Correct
AnswersSymtoms: Nausea, photophobia, phonophobia and exacerbation with physical
activtiy
THREE OR MORE = MIGRAINE
< THREE = r/o MIGRAINE
McPhee p 39
Critical components of physical exam for complaint of HA? - Correct Answers+ Vital
signs
+ Complete neuro exam
+ Vision testing (with funduscopic exam)
McPhee p 40
Kernig and Brudzinski signs are indicative of what? - Correct AnswersMeningeal
irritation
McPhee p 40
Scalp and temporal artery tenderness should be performed on pts with HA who are >
______________ years. - Correct Answers> 60
McPhee p 40
Components of visual exam for pt presenting with HA? - Correct Answers+ Visual acuity
(Snellen)
+ Ocular gaze (Motor test - 9 positions)
+ Visual fields (Cover test - central/periph vision)
,+ Pupillary defects (Size, dilation)
+ Optic disks
+ Retinal vein pulsations
McPhee p 40
Pt with HA and *diminished visual acuity* suggests.... - Correct Answers+ Glaucoma
+ Temporal arteritis
+ Optic neuritis
McPhee p 40
Pt with HA and *ophthalmoplegia or visual field defects* suggests.... - Correct Answers+
Venous sinus thrombosis
+ Tumor
+ Aneurysm
McPhee p 40
Pt with HA and *hypertension, "cotton wool spots", flame hemorrhages and disk
swelling* suggests.... - Correct Answers+ Acute severe hypertensive retinopathy
McPhee p 40
Pt with HA and *ipsilateral ptosis and miosis* suggests.... - Correct AnswersHorner
syndrome AND/OR carotid artery dissection
McPhee p 40
Pt with HA and *papilledema or absent retinal venous pulsations* suggests.... - Correct
Answers↑ ICP
+ Follow with neuroimaging prior to performing lumbar puncture
McPhee p 40
ANY abnormality on neuro exam (esp mental status) of pt with HA warrants.... - Correct
Answers+ EMERGENT neuroimaging
McPhee p 40
Ottawa criteria for evaluation of pts presenting with acute non-traumatic headache for
signs of subarachnoid hemorrhage - Correct Answers+ ≥ 40 years of age
+ Neck pain/stiffness
+ Witnessed loss of consciousness
+ Onset during exertion
+ Thunderclap headache
, + Limited neck flexion on examination
McPhee p 41
What kind of early treatment of diagnosed migraine or migraine-like headache can abort
or provide significant relief of symptoms? - Correct Answers+ NSAIDs (e.g. ketorolac)
+ Triptans
McPhee p 41
What types of headaches may respond well to high-flow O2 therapy? - Correct
AnswersALL types
McPhee p 41
What types of headaches should be referred? - Correct Answers+ Frequent migraines
not responsive to std tx
+ Migraines with atypical features
+ Chronic daily ha r/t medication overuse
McPhee p 41
Primary headache syndromes? - Correct Answers+ Migraine
+ Tension-type headache
+ Cluster headache
McPhee p 986
Secondary causes of headache? - Correct AnswersSome examples:
+ Intracranial lesions
+ Head injury
+ Cervical spondylosis
+ Dental/ocular disease
+ TMJ dysfunction
+ Sinusitis
+ Hypertension
+ Depression
McPhee p 986
Common age of onset of migraines? - Correct AnswersAdolescence or early adult life
McPhee p 986
Symptoms of migrainous headaches - Correct Answers+ Usually lateral, can be
generalized
