NM703 -Highlights of Neuro, Muskuloskeletal, &
Mental health | Exam Questions with Revised
Answers| Verified 100% Correct
What is something to consider if a patient presents with daily headaches but also utilize
OTC medications frequently for them? - ✔✔-Rebound headaches
What is the first line abortive treatment for mild-moderate headaches? - ✔✔-NSAID
analgesics
What is a good go-to medication to help increase the effectiveness of an abortive
medication for a migraine? - ✔✔-Reglan (helps increase gastric motility which is
usually turned off during a migraine--this will help increase absorption of abortive
medication)
What classes are good for abortive treatment of headaches that are moderate-severe? -
✔✔-triptans & ergots (vasoconstrictors)
-do not use in pregnancy*
-caution in those with HTN
When would a preventative medication be indicated for headache management? What
medications are available as prevention? - ✔✔-headaches occur >4X month
-severe
-do not respond well to abortive medications
-Beta blockers*, Ca channel blockers, anticonvulsants, TCAs, SSRIs
,What are red flags and indications for referrals with headaches? - ✔✔-new onset of
headache as "worst headache of my life"
-new onset headache in someone >50
-associated with any neurologic symptoms
What is vertigo? - ✔✔-sensation of spinning or that the environment is spinning
around them
-peripheral* or central causes
Types of peripheral vertigo? - ✔✔-BPPV
-Menieres disease
-Vestibular neuronitis
BPPV (benign paroxysmal positional vertigo): - ✔✔-most common type--especially in
elderly
-free floating crystal particles move around the semicircular canal with head movements
-abrupt position changes usually triggers it
-usually resolves on own
-refer to vestibular physical therapy to shorten recovery time*
-teach Epleys maneuver to do at home as will often reoccur*
-Meclizine can be used but usually isn't as effective
Menieres disease: - ✔✔-disorder of the inner ear usually unilateral
-unrelated to position changes
-usually associated with hearing loss, tinnitus, aural fullness
-hearing loss initially reversible but can become permanent
, -caffeine, alcohol, tobacco can worsen it*
-Refer to otolaryngologist
-can prescribe antiverts like meclizine and antiemetics while waiting for appointment*
Vestibular neuronitis: - ✔✔-"acute labyrinthitis"
-viral infection of the inner ear
-usually also involves cochlea and has the potential to cause hearing loss*
-frequently associated with recent URI
-usually self-limiting--resolves within 3-6 weeks
-will usually refer*
-lying in dark room can help symptoms
What medications can use acutely for vestibular neuronitis but need to be stopped after
a few days? - ✔✔-antiverts & antiemetics
-continued use can prolong recovery
What things might also cause vertigo that need to be considered? - ✔✔-drugs
(particularly the elderly)
-hypo/hyperglycemia
-electrolyte imbalances
-anemia
Weber test: - ✔✔-stem of a vibrating tuning fork on the midline of the head--sounds
usually will be bilateral and equal in both ears
-if lateralization of sound toward unaffected ear--sensorineural hearing loss found in
menieres and labyrinthitis*
Mental health | Exam Questions with Revised
Answers| Verified 100% Correct
What is something to consider if a patient presents with daily headaches but also utilize
OTC medications frequently for them? - ✔✔-Rebound headaches
What is the first line abortive treatment for mild-moderate headaches? - ✔✔-NSAID
analgesics
What is a good go-to medication to help increase the effectiveness of an abortive
medication for a migraine? - ✔✔-Reglan (helps increase gastric motility which is
usually turned off during a migraine--this will help increase absorption of abortive
medication)
What classes are good for abortive treatment of headaches that are moderate-severe? -
✔✔-triptans & ergots (vasoconstrictors)
-do not use in pregnancy*
-caution in those with HTN
When would a preventative medication be indicated for headache management? What
medications are available as prevention? - ✔✔-headaches occur >4X month
-severe
-do not respond well to abortive medications
-Beta blockers*, Ca channel blockers, anticonvulsants, TCAs, SSRIs
,What are red flags and indications for referrals with headaches? - ✔✔-new onset of
headache as "worst headache of my life"
-new onset headache in someone >50
-associated with any neurologic symptoms
What is vertigo? - ✔✔-sensation of spinning or that the environment is spinning
around them
-peripheral* or central causes
Types of peripheral vertigo? - ✔✔-BPPV
-Menieres disease
-Vestibular neuronitis
BPPV (benign paroxysmal positional vertigo): - ✔✔-most common type--especially in
elderly
-free floating crystal particles move around the semicircular canal with head movements
-abrupt position changes usually triggers it
-usually resolves on own
-refer to vestibular physical therapy to shorten recovery time*
-teach Epleys maneuver to do at home as will often reoccur*
-Meclizine can be used but usually isn't as effective
Menieres disease: - ✔✔-disorder of the inner ear usually unilateral
-unrelated to position changes
-usually associated with hearing loss, tinnitus, aural fullness
-hearing loss initially reversible but can become permanent
, -caffeine, alcohol, tobacco can worsen it*
-Refer to otolaryngologist
-can prescribe antiverts like meclizine and antiemetics while waiting for appointment*
Vestibular neuronitis: - ✔✔-"acute labyrinthitis"
-viral infection of the inner ear
-usually also involves cochlea and has the potential to cause hearing loss*
-frequently associated with recent URI
-usually self-limiting--resolves within 3-6 weeks
-will usually refer*
-lying in dark room can help symptoms
What medications can use acutely for vestibular neuronitis but need to be stopped after
a few days? - ✔✔-antiverts & antiemetics
-continued use can prolong recovery
What things might also cause vertigo that need to be considered? - ✔✔-drugs
(particularly the elderly)
-hypo/hyperglycemia
-electrolyte imbalances
-anemia
Weber test: - ✔✔-stem of a vibrating tuning fork on the midline of the head--sounds
usually will be bilateral and equal in both ears
-if lateralization of sound toward unaffected ear--sensorineural hearing loss found in
menieres and labyrinthitis*
