Chapter 10 - Headache

Question 1

Which of the following cranial structures are NOT pain-sensitive?*
A. Facial muscles
B. Intracranial venous sinuses
C. Arteries within the dura
D. Middle meningeal artery
E. C1-3
F. Parietal cortex

Answer 1

F. Parietal cortex (p. 169)

Question 2

Which does NOT consistently produce cranial pain?*
A. Areas near the cranial insertion of cervical muscles
B. Traction on dural attachments and dural sinuses
C. Neurogenic inflammation
D. Increased ICP
E. Vasodilation

Answer 2

D. Increased ICP (p. 170)

Question 3

Known as classic or neurologic migraine
A. Migraine with aura
B. Migraine without aura
C. Both A and B
D. None of the above

Answer 3

A. Migraine with aura (p. 172)

Question 4

Ushered in by a disturbance of neurologic function
A. Migraine with aura
B. Migraine without aura
C. Both A and B
D. None of the above

Answer 4

A. Migraine with aura (p. 172)

Question 5

Photo-, phono-, and osmophobia are characteristic
A. Migraine with aura
B. Migraine without aura
C. Both A and B
D. None of the above

Answer 5

C. Both A and B (p. 172)

Question 6

Unformed flashes of white or silver, or rarely, of multicolored lights
A. Photopsia
B. Scintillating scotoma
C. Fortification spectra or teichopsia
D. Scotoma

Answer 6

A. Photopsia (p. 175)

Question 7

Enlarging blind spot with a shimmering edge
A. Photopsia
B. Scintillating scotoma
C. Fortification spectra or teichopsia
D. Scotoma

Answer 7

B. Scintillating scotoma (p. 175)

Question 8

Formation of dazzling zigzag lines arranged like the battlements of a castle
A. Photopsia
B. Scintillating scotoma
C. Fortification spectra or teichopsia
D. Scotoma

Answer 8

C. Fortification spectra or teichopsia (p. 175)

Question 9

Island of visual loss
A. Photopsia
B. Scintillating scotoma
C. Fortification spectra or teichopsia
D. Scotoma

Answer 9

D. Scotoma (p. 175)

Question 10

True of spreading cortical depression in migraine*
A. There is reduction in regional blood flow from the frontal to the occipital cortex.
B. A Noxious stimulus applied to the rat cortex was followed by vasconstriction and slowly spreading waves of inhibition of the electrical activity of cortical neurons.
C. There is dilation of the posterior cerebral arteries bilaterally.
D. All of the above

Answer 10

B. A Noxious stimulus applied to the rat cortex was followed by vasconstriction and slowly spreading waves of inhibition of the electrical activity of cortical neurons. (p. 179)

Question 11

Which among the following beta blockers lack agonist properties, and are thus given as alternative preventive treatment for migraine?
A. Atenolol
B. Timolol
C. Metoprolol
D. All of the above

Answer 11

D. All of the above (p. 182)

Question 12

Which among the following are indomethacin responsive headaches?
A. Valsalva related headaches
B. Trigeminal-autonomic cephalgias
C. SUNCT
D. Stabbing headaches
E. All of the above

Answer 12

E. All of the above (Table 10-3, p. 183)

Question 13

A 30-year-old male patient presents with persistent very intense non-throbbing headache that wakens him up every night. What is the most likely diagnosis?*
A. Migraine with aura
B. Migraine with brainstem aura
C. Common migraine
D. Paroxysmal nocturnal cephalgia
E. None of the above

Answer 13

D. Paroxysmal nocturnal cephalgia (p. 183)

Question 14

Most important feature of chronic paroxysmal hemicrania that distinguishes it from cluster headache
A. Shorter duration
B. Location
C. Duration of paroxysm
D. Responsive to indomethacin

Answer 14

D. Responsive to indomethacin (p. 184)

Question 15

The following features differentiate cluster headache from migraine EXCEPT
A. Flushing of the face on the side of a cluster headache; pallor in migraine
B. Increased intraocular pressure in cluster HA; normal in migraine
C. Decreased skin temperature over the forehead, temple, and cheek in cluster HA; increased temperature in migraine
D. All of the above are true

Answer 15

C. Decreased skin temperature over the forehead, temple, and cheek in cluster HA; increased temperature in migraine (p. 184)

Question 16

Most common variety of headache
A. Migraine with aura
B. Migraine without aura
C. Cluster headache
D. Tension headache

Answer 16

D. Tension headache (p. 185)

Question 17

The only type of headache that exhibitis the peculiarity of being present throughout the day, day after day, for long periods of time
A. Migraine with aura
B. Migraine without aura
C. Cluster headache
D. Tension headache

Answer 17

D. Tension headache (p. 185)

Question 18

The following features distinguish tension headache from migraine EXCEPT
A. Non-throbbing character
B. Absence of nausea, photo-/phonophobia
C. Absence of clear lateralization
D. Onset is less gradual compared to migraine
E. All of the above are true

Answer 18

D. Onset is less gradual compared to migraine (p. 185)

Question 19

Most sensitive test for headache of temporal arteritis
A. ESR
B. CRP
C. Arteriography of external carotid artery branches
D. Ultrasonography of the temporal arteries

Answer 19

C. Arteriography of the external carotid artery branches (p. 188)

Question 20

Most likely diagnosis for a patient with recurrent unilateral headaches and transient ophthalmoplegia and ptosis*
A. Diabetic ophthalmoparesis
B. Ophthalmoplegic migraine
C. Temporal arteritis
D. Basilar migraine

Answer 20

B. Ophthalmoplegic migraine (p. 176)