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Assessment Midterm: HEENT (Bates) Questions and
Answers with Complete Solutions UPDATED!!!
Primary headaches include - ANSWER migraine, tension, cluster,
and chronic daily headaches
Secondary headaches include - ANSWER headaches arising
from underlying structural, systemic, or infectious causes such
as meningitis or subarachnoid hemorrhage and may be life-
threatening
Thunderclap headaches - ANSWER reach maximal intensity over
several minutes, occur in 70% of patients with subarachnoid
hemorrhage, and are often preceded by a sentinel leak
headache from a vascular leak into the subarachnoid space
The most important attributes of headache are - ANSWER its
severity and chronologic pattern
Headache Warning Signs ("red flags" that need prompt
investigation) - ANSWER 1. Progressively frequent or severe
over a 3-month period 2. Sudden onset like a "thunderclap" or
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"the worst headache of my life" 3. New onset after age 50 years
4. Aggravated or relieved by change in position 5. Precipitated
by Valsalva maneuver 6. Associated symptoms of fever, night
sweats, or weight loss 7. Presence of cancer, HIV infection, or
pregnancy 8. Recent head trauma 9. Associated papilledema,
neck stiffness, or focal neurologic deficits
If headache is severe and of sudden onset, consider - ANSWER
subarachnoid hemorrhage or meningitis
What types of headaches are episodic and tend to peak over
several hours - ANSWER migraine and tension headaches
New and persisting, progressively severe headaches raise
concerns of - ANSWER tumor, abscess, or mass lesion
Unilateral headache occurs in - ANSWER migraine and cluster
headaches
Tension headaches often arise in what area - ANSWER the
temporal areas
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Cluster headaches may arise in what area - ANSWER retro-
orbital
Nausea and vomiting occur with what - ANSWER commonly
with migraines, but also with brain tumors and subarachnoid
hemorrhage
What percentage of patients with migraine have a symptom
prodrome prior to onset - ANSWER 60-70%
1/3 of patients with migraine experience - ANSWER a visual
aura, such as spark photopsias (flashes of light), fortifications
(zig-zag arcs of light), and scotoma (area of visual loss with
surrounding normal vision)
Due to increased risk of ischemic stroke and cardiovascular
disease, the World Health Association advises women with
migraines over age 35 and women with migraines with aura
avoid use of what - ANSWER estrogen-progestin contraceptives
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Valsalva maneuvers may increase headache pain from -
ANSWER acute sinusitis or from mass lesion due to changing
intracranial pressure
Medication for overuse headache is indicated if - ANSWER
analgesics/ergotamines/triptans present >/= 15 days a month
for three months and reverts to </= 15 days a month when the
medication is discontinued
Medical terms for farsightedness, aging vision, and
nearsightedness - ANSWER hyperopia; presbyopia; myopia
If sudden unilateral visual loss is painless consider - ANSWER
vitreous hemorrhage from diabetes or trauma, macular
degeneration, retinal detachment, retinal vein occlusion, or
central retinal artery occlusion
If sudden unilateral visual loss is painful consider - ANSWER
causes that are usually in the cornea and anterior chamber as in
corneal ulcer, uveitis, traumatic hyphen, and acute glaucoma,
optic neuritis from MS may also be painful
Assessment Midterm: HEENT (Bates) Questions and
Answers with Complete Solutions UPDATED!!!
Primary headaches include - ANSWER migraine, tension, cluster,
and chronic daily headaches
Secondary headaches include - ANSWER headaches arising
from underlying structural, systemic, or infectious causes such
as meningitis or subarachnoid hemorrhage and may be life-
threatening
Thunderclap headaches - ANSWER reach maximal intensity over
several minutes, occur in 70% of patients with subarachnoid
hemorrhage, and are often preceded by a sentinel leak
headache from a vascular leak into the subarachnoid space
The most important attributes of headache are - ANSWER its
severity and chronologic pattern
Headache Warning Signs ("red flags" that need prompt
investigation) - ANSWER 1. Progressively frequent or severe
over a 3-month period 2. Sudden onset like a "thunderclap" or
,2|Page
"the worst headache of my life" 3. New onset after age 50 years
4. Aggravated or relieved by change in position 5. Precipitated
by Valsalva maneuver 6. Associated symptoms of fever, night
sweats, or weight loss 7. Presence of cancer, HIV infection, or
pregnancy 8. Recent head trauma 9. Associated papilledema,
neck stiffness, or focal neurologic deficits
If headache is severe and of sudden onset, consider - ANSWER
subarachnoid hemorrhage or meningitis
What types of headaches are episodic and tend to peak over
several hours - ANSWER migraine and tension headaches
New and persisting, progressively severe headaches raise
concerns of - ANSWER tumor, abscess, or mass lesion
Unilateral headache occurs in - ANSWER migraine and cluster
headaches
Tension headaches often arise in what area - ANSWER the
temporal areas
,3|Page
Cluster headaches may arise in what area - ANSWER retro-
orbital
Nausea and vomiting occur with what - ANSWER commonly
with migraines, but also with brain tumors and subarachnoid
hemorrhage
What percentage of patients with migraine have a symptom
prodrome prior to onset - ANSWER 60-70%
1/3 of patients with migraine experience - ANSWER a visual
aura, such as spark photopsias (flashes of light), fortifications
(zig-zag arcs of light), and scotoma (area of visual loss with
surrounding normal vision)
Due to increased risk of ischemic stroke and cardiovascular
disease, the World Health Association advises women with
migraines over age 35 and women with migraines with aura
avoid use of what - ANSWER estrogen-progestin contraceptives
, 4|Page
Valsalva maneuvers may increase headache pain from -
ANSWER acute sinusitis or from mass lesion due to changing
intracranial pressure
Medication for overuse headache is indicated if - ANSWER
analgesics/ergotamines/triptans present >/= 15 days a month
for three months and reverts to </= 15 days a month when the
medication is discontinued
Medical terms for farsightedness, aging vision, and
nearsightedness - ANSWER hyperopia; presbyopia; myopia
If sudden unilateral visual loss is painless consider - ANSWER
vitreous hemorrhage from diabetes or trauma, macular
degeneration, retinal detachment, retinal vein occlusion, or
central retinal artery occlusion
If sudden unilateral visual loss is painful consider - ANSWER
causes that are usually in the cornea and anterior chamber as in
corneal ulcer, uveitis, traumatic hyphen, and acute glaucoma,
optic neuritis from MS may also be painful
