Headaches

Question 1

If a patient with a history of migraine presents with a headache that is worse than her usual headache what should you do?

Answer 1

get a CT scan

Question 2

A patient with a history of migraine presents with a headache that is worse than her usual headache. You get a CT scan and it is negative. What do you want to do next?

Answer 2

LP to assess for SAH

Question 3

What goes in each of the 4 tubes for an LP?

Answer 3

• 1 = cells
• 2 = protein/glucose
• 3 = cultures
• 4 = cells (if suspect SAH)

Question 4

If a patient is on anticoagulant and suffers a fall. What should you always be concerned for?

Answer 4

subdural hematoma

check your own CT scan

Question 5

Hyperactive LE with cross adductors is a upper or lower motor neuron problem?

Answer 5

upper motor neuron problem

Question 6

20 yr old college student presents with a headache for the last few weeks. Coughing and sneezing makes the headache worse. What should you be concerned for?

Answer 6

• posterior fossa tumor

Question 7

What is the best imaging modality to access for a brain tumor?

Answer 7

MRI

Question 8

Any patient with a severe spinal injury you need to perform this physical exam.

Answer 8

rectal exam

Question 9

In any patient with a C-spine injury before you take him to the OR you need to get this imaging study.

Answer 9

CTA to check for resection of carotid arteries

Question 10

In a young female patient who complains of a dull headache for the past few months with associated vision changes what should you be concerned for?

Answer 10

prolactinoma

Question 11

After you remove a prolactinoma what do you need to monitor for?

Answer 11

diabetes insipidus

Question 12

A sinus venous thrombosis increases the ______ pressure

Answer 12

Intra-cranial pressure (ICP)

Question 13

What is the treatment for a sinus venus thrombosis?

Answer 13

• LMWH

* if the patient has covid = no heparin*

Question 14

A patient presents with a headache, nausea and photophobia with a blood pressure of 180/120. What diagnosis should you be concerned for?

Answer 14

reversible cerebral vasoconstriction (RCVS)

treatment is to control the BP

Question 15

A patient presents with severe pain over the right orbit that lasts 90-120 minutes. What type of headache is this?

Answer 15

cluster headache

Question 16

A patient presents with daily headaches. It starts in the middle of the day and feels like a tightness all over his head. He works in front of a computer all day. What type of headache is this?

Answer 16

tension headache