Headache and pain Flashcards
What is the most prevalent type of primary headaches?
A) Tension-type headache
B) migraine without aura
C) cluster headache
D) migraine with aura
A) Tension-type headache
Characteristic features of migraine, except:
A) pulsating pain
B) mostly unilateral
C) physical activity increases the intensity
D) dizziness
E) duration is 4–72 hours
D) dizziness
The average duration of migraine attacks is:
A) less, than 4 hours
B) 0.5-1 day
C) 4 days
D) one week
B) 0.5-1 day
What is the prevalence of migraine in adults?
A) 1–2%
B) 5–7%
C) 8–12%
D) more, than 20%
C) 8–12%
Which accompanying sign is not a diagnostic feature of migraine?
A) nausea, vomiting
B) phonophobia
C) photophobia
D) osmophobia (hypersensitivity to odors)
D) osmophobia (hypersensitivity to odors)
Which primary headache is more prevalent in males than in females?
A) migraine with aura
B) migraine without aura
C) tension-type headache
D) cluster headache
D) cluster headache
The onset of primary headaches may be, except:
A) in childhood
B) at young age (in the 2–3. decades)
C) in the 4th decade
D) above 60. years
D) above 60. years
Accompanying signs of cluster headache, except:
A) miosis
B) ptosis
C) conjunctival injection
D) paraesthesia on the contralateral side of the headache
E) bradycardia
D) paraesthesia on the contralateral side of the headache
What is the menstrual migraine?
A) subtype of migraine with a specific condition where the timing of attacks is linked to the menstrual cycle
B) migraine, where at least one of the attacks occurs during menstrual period
C) the most severe headaches occur during menstrual period
D) headaches exclusively occur between the menarche and climax
A) subtype of migraine with a specific condition where the timing of attacks is linked to the menstrual cycle
What is the characteristic nerve conduction velocity of unmyelinitaed pain-transmitting C fibers?
A) 70–120 m/s
B) 70–100 m/s
C) 15–40 m/s
D) 0.2–2 m/s
D) 0.2–2 m/s
What is lateral cordotomy?
A) lesion in the ventral posterolateral nucleus of the thalamus
B) incision of the posterior funiculus in the spinal cord
C) a surgical procedure that injures the spinothalamic lateral tract in the spinal cord
D) electric stimulation of periaqueductal gray matter in the brainstem in order to alleviate severe pain
C) a surgical procedure that injures the spinothalamic lateral tract in the spinal cord
Abdominal lancinating pain is a characteristic sign of:
A) spinal cord disease
B) tabes dorsalis
C) trigeminal-neuralgia
D) multiple mononeuritis
B) tabes dorsalis
What can not be the cause of trigeminal neuralgia?
A) idiopathic origin
B) multiple sclerosis
C) somatoform disturbance
D) cancer
C) somatoform disturbance
What is the difference between neuralgic and radicular pain?
A) characteristics of the pain
B) intensity of the pain
C) the pain can not be well localized
D) duration of the pain
D) duration of the pain
What is the diagnosis of the case: The patient has paroxysmal attacks with lancinating pain, restricted always to one side of the throat, back of the tongue, tonsil and ear. The pain lasts for seconds and can be triggered by swallowing (drinking liquids).
A) trigeminal-neuralgia
B) glossopharyngeal-neuralgia
C) occipital-neuralgia
D) tonsillitis
B) glossopharyngeal-neuralgia
Which one is contraindicated for migraine prophylaxis?
A) antihistamine, antiserotonine drugs
B) anticonvulsants
C) calcium channel blockers
D) ergotamine, dihydroergotamine preparations
D) ergotamine, dihydroergotamine preparations
Useful in acute cluster headache, except for:
A) O2 inhalation
B) indometacine
C) sumatriptane
D) lithium
D) lithium
Which one is effective in prophylaxis of cluster headache?
A) beta blockers
B) minor analgesics
C) calcium channel blockers
D) tricyclic antidepressants
C) calcium channel blockers
It can be effective in the treatment of tension type headache:
A) antihistamines
B) antihypertensives
C) tricyclic antidepressants
D) MAO-inhibitors
C) tricyclic antidepressants
A 45-year-old men lifting a heavy object experienced a sudden low back pain. The pain irradiates to his right buttock, posterior thigh, popliteal region and little toe. Upon examination he had Lasegue sign on the right side, missing right Achilles reflex and hypaesthesia of the little toe. Which root is affected?
A) L2 root
B) L3 root
C) L4 root
D) L5 root
E) S1 root
E) S1 root
First choice of treatment for trigeminal neuralgia is:
A) clonazepam
B) alcoholic ganglion infiltration
C) carbamazepine
D) retroganglionar neurotomy
E) none of them
C) carbamazepine
Which symptom can be caused by unruptured intracranial aneurysm?
A) signs of oculomotor nerve lesion
B) visual field defect
C) ipsilateral recurring headache
D) ipsilateral facial pain
E) all of them
E) all of them
A 50-year-old man experienced a sudden-onset headache during physical exercise with stiff neck, seizures, oculomotor nerve palsy and quickly developed coma. The probable diagnosis is:
A) bacterial meningitis
B) spontaneous aneurysmal subarachnoid haemorrhage
C) ruptured brain abscess
D) haemorrhage in a glioma
E) brain metastasis
B) spontaneous aneurysmal subarachnoid haemorrhage
The least typical statement for temporal arteritis:
A) steroid treatment can only be administered if biopsy confirmed the diagnosis
B) occurs above 50 years of age
C) a subtype of giant cell arteritis
D) characterized by headache, elevated erythrocyte sedimentation rate
A) steroid treatment can only be administered if biopsy confirmed the diagnosis
Characteristic for alcoholic polyneuopathy:
A) persistent lancinating pain
B) sensory disturbance of the lower extremities, diminished reflexes
C) no vegetative symptoms
D) normal conduction velocity of the peroneal nerve
E) hyperthermia
B) sensory disturbance of the lower extremities, diminished reflexes
Typical in Wallenberg syndrome:
A) contralateral pain
B) ipsilateral hypalgesia
C) contralateral hemihypalgesia
D) ipsilateral facial hypalgesia and contralateral hypalgesia below C2
D) ipsilateral facial hypalgesia and contralateral hypalgesia below C2
What is dissociated sensory loss?
A) loss of pain sensation, but temperature sensation is intact
B) pain sensation is intact, but loss of temperature sensation
C) pain sensation is intact, but loss of temperature, vibration and joint position sense
D) loss of pain and temperature sensation, but vibration and joint position sense intact
D) loss of pain and temperature sensation, but vibration and joint position sense intact
Bending down the head worsens the headache, if it is caused by:
A) glaucoma
B) maxillary sinusitis
C) tension type headache
D) cluster headache
B) maxillary sinusitis
Symmetric burning, stabbing pain at the distal part of the extremities, especially on the legs typical for:
A) polyneuropathy
B) radiculitis
C) myositis
D) Lambert–Eaton syndrome
A) polyneuropathy
Typical in migraine, except for:
A) unilateral in more than half of the cases
B) frequently vegetative symptoms
C) EEG always negative
D) ocular symptom in ophtalmoplegic migraine may last for several days
E) frequently aspirin is effective
C) EEG always negative
80 years old alcoholic patient fell and had a head injury one moth ago, he has complained headache for 2-3 weeks, and has developed a progressing left sided hemiparesis and anisocoria. The most likely diagnosis is:
A) cerebral contusion
B) right sided frontal lobe glioblastoma
C) right sided subdural haematoma
D) occlusion of the right sided middle cerebral artery
C) right sided subdural haematoma
Shooting pain, dysuria, ataxia associated with pupil disorder, areflexia, and proprioceptiv sensory disturbance suggest the following disease:
A) Mixed connective tissue disease
B) Tabes dorsalis
C) Multiple sclerosis
D) Syringomyelia
B) Tabes dorsalis
Trigeminal-neuralgia is the least common in the following division of the trigeminal nerve:
A) V/2
B) V/3
C) V/1
D) V/2 + V/3
C) V/1
A 54-year-old hypertonic male patient presented with sudden onset of vertigo, headache and vomiting. At the examination the patient was alert, he had nystagmus and one sided limb ataxia without paresis. Which diagnosis is the most likely?
A) pons bleeding
B) bleeding in the internal capsule
C) cerebellar bleeding
D) subarachnoideal haemorrhage
E) basilar artery aneurysm
C) cerebellar bleeding
What is the order of the appearance of herpes zoster symptoms:
A) pain-vesicles-pigmentation
B) vesicles–pigmentation–pain
C) pain–pigmentation–vesicles
D) pigmentation– vesicles–pain
E) vesicles–pain–pigmentation
A) pain-vesicles-pigmentation
Herpes zoster most often affects the:
A) ganglion geniculi
B) the maxillary division of the trigeminal nerve
C) the cervical region
D) the thoracic region
E) the lumbar region
D) the thoracic region
Childhood head injury is frequently associated with the following symptom(s):
A) vertigo
B) epileptic seizure
C) headache
D) all of them
E) none of them
D) all of them
The first symptom(s) of the brain tumor in childhood:
A) seizure and coma
B) change of behavior
C) headache and vomiting
D) hemiparesis and hyperreflexia
E) none of them
C) headache and vomiting
In a 31-year-old man constant bifrontal headache and blurred vision has been present for 2 weeks. In the last 1 week he became somnolent, sometimes he slept 20 hours. In a previous history, there was an accident 3 months ago, when he fell down from a moving vehicle and he hit his head, the skin of the skull was lacerated. During the examination bilateral papilla edema, dilated right pupil and left hemiparesis were observed. The most probable diagnosis is:
A) dementia paralytica
B) chronic subdural haematoma
C) bromine intoxication
D) brain haemorrhage
B) chronic subdural haematoma
Which disease is associated with the following signs and symptoms: headache, anemia, polymyalgia rheumatica, increased erythrocyte sedimentation rate (ESR), jaw claudication, low fever and leukocytosis?
A) meningitis tubercolosa
B) lupus erythematosus
C) arteritis temporalis
C) arteritis temporalis