LEHNE PHARM MIGRAINE & HEADACHE
PHARMACOTHERAPY LATEST UPDATED 2026-2027
EXAM WITH VERIFIED ANSWERS, 100+ QUESTIONS
WITH RATIONALES. A+ GRADED
1. Migraine headache is best described as:
A. Bilateral, pressing pain lasting seconds
B. Sudden thunderclap headache with fever
C. Unilateral, throbbing pain lasting 4–72 hours with nausea
D. Occipital pain worsened by coughing
Rationale: Migraine is typically unilateral, pulsating, moderate–severe, and
associated with nausea, photophobia, and phonophobia.
2. Which neurotransmitter is most strongly implicated in migraine
pathophysiology?
A. Dopamine
B. GABA
C. Acetylcholine
D. Calcitonin gene-related peptide (CGRP)
Rationale: CGRP is released from trigeminal neurons and contributes to
vasodilation and neurogenic inflammation.
3. A migraine aura typically lasts:
A. <1 minute
B. 5–60 minutes
C. 2–6 hours
D. 24–72 hours
,Rationale: Aura symptoms are transient neurologic disturbances lasting less than
60 minutes.
4. First-line treatment for mild acute migraine is:
A. Triptans
B. Ergotamine
C. NSAIDs (e.g., ibuprofen, naproxen)
D. Opioids
Rationale: NSAIDs are first-line for mild to moderate attacks.
5. A key mechanism of triptans is:
A. Dopamine antagonism
B. CGRP synthesis inhibition
C. 5-HT1B/1D receptor agonism causing vasoconstriction
D. Histamine blockade
Rationale: Triptans constrict cranial vessels and inhibit neuropeptide release via
serotonin receptors.
6. Which drug class is contraindicated in ischemic heart disease due to
vasoconstriction risk?
A. NSAIDs
B. Antiemetics
C. Triptans
D. Antihistamines
Rationale: Triptans cause vasoconstriction and are avoided in cardiovascular
disease.
, 7. A common migraine-associated symptom is:
A. Bradycardia
B. Photophobia
C. Jaundice
D. Hematuria
Rationale: Sensory hypersensitivity (light, sound, smell) is typical.
8. Which medication is used for both nausea and migraine pain relief?
A. Metformin
B. Metoclopramide
C. Omeprazole
D. Loperamide
Rationale: Dopamine antagonists like metoclopramide treat nausea and enhance
analgesia.
9. Preventive migraine therapy is indicated when:
A. One mild attack per year
B. Frequent disabling attacks (>2 per week or severe disability)
C. Only aura without headache
D. Headache lasts <30 minutes
Rationale: Prophylaxis is used when attacks are frequent or disabling.
10.Which beta-blocker is commonly used for migraine prophylaxis?
A. Atenolol only
B. Propranolol
C. Labetalol
D. Dobutamine
Rationale: Propranolol is a first-line preventive agent.
PHARMACOTHERAPY LATEST UPDATED 2026-2027
EXAM WITH VERIFIED ANSWERS, 100+ QUESTIONS
WITH RATIONALES. A+ GRADED
1. Migraine headache is best described as:
A. Bilateral, pressing pain lasting seconds
B. Sudden thunderclap headache with fever
C. Unilateral, throbbing pain lasting 4–72 hours with nausea
D. Occipital pain worsened by coughing
Rationale: Migraine is typically unilateral, pulsating, moderate–severe, and
associated with nausea, photophobia, and phonophobia.
2. Which neurotransmitter is most strongly implicated in migraine
pathophysiology?
A. Dopamine
B. GABA
C. Acetylcholine
D. Calcitonin gene-related peptide (CGRP)
Rationale: CGRP is released from trigeminal neurons and contributes to
vasodilation and neurogenic inflammation.
3. A migraine aura typically lasts:
A. <1 minute
B. 5–60 minutes
C. 2–6 hours
D. 24–72 hours
,Rationale: Aura symptoms are transient neurologic disturbances lasting less than
60 minutes.
4. First-line treatment for mild acute migraine is:
A. Triptans
B. Ergotamine
C. NSAIDs (e.g., ibuprofen, naproxen)
D. Opioids
Rationale: NSAIDs are first-line for mild to moderate attacks.
5. A key mechanism of triptans is:
A. Dopamine antagonism
B. CGRP synthesis inhibition
C. 5-HT1B/1D receptor agonism causing vasoconstriction
D. Histamine blockade
Rationale: Triptans constrict cranial vessels and inhibit neuropeptide release via
serotonin receptors.
6. Which drug class is contraindicated in ischemic heart disease due to
vasoconstriction risk?
A. NSAIDs
B. Antiemetics
C. Triptans
D. Antihistamines
Rationale: Triptans cause vasoconstriction and are avoided in cardiovascular
disease.
, 7. A common migraine-associated symptom is:
A. Bradycardia
B. Photophobia
C. Jaundice
D. Hematuria
Rationale: Sensory hypersensitivity (light, sound, smell) is typical.
8. Which medication is used for both nausea and migraine pain relief?
A. Metformin
B. Metoclopramide
C. Omeprazole
D. Loperamide
Rationale: Dopamine antagonists like metoclopramide treat nausea and enhance
analgesia.
9. Preventive migraine therapy is indicated when:
A. One mild attack per year
B. Frequent disabling attacks (>2 per week or severe disability)
C. Only aura without headache
D. Headache lasts <30 minutes
Rationale: Prophylaxis is used when attacks are frequent or disabling.
10.Which beta-blocker is commonly used for migraine prophylaxis?
A. Atenolol only
B. Propranolol
C. Labetalol
D. Dobutamine
Rationale: Propranolol is a first-line preventive agent.
