Neuro: HA

Question 1

MC HA Dx

Answer 1

migraine

Question 2

Most debilitating HA

Answer 2

cluster

Question 3

Most frequent HA

Answer 3

tension

Question 4

Triad for migraines…

Answer 4

photophobia
incapacity
nausea

Question 5

Throbbing, pulsatile HA

nausea
confusion
blurred vision
photo/phonophobia
no warning

Answer 5

common migraine

Question 6

What stage of migraine?

Food cravings, mood change, uncontrollable yawning, fluid
retention, constipation, neck stiffness

Answer 6

prodrome

Question 7

Unilateral, throbbing pain w/ N/V and/or photo/phonopobia

Answer 7

migraine

Question 8

Dx of migraine

Answer 8

clinical

Question 9

Migraine with the below warrants…

• “Worst headache of my life”
• Changes in HA presentation
• New or unexplained neurologic symptoms
• HA not responding to treatment
• New onset after 50 or in pts with CA or HIV

Answer 9

CT

Question 10

Mod-Severe migraine Tx

Answer 10

triptans

Question 11

The below are SEs of…

Injection site reaction, chest pressure or
heaviness, flushing, weakness, drowsiness,
dizziness, malaise, feeling of warmth,
paresthesia
• Resolve in 30 minutes

Answer 11

triptans

Question 12

C/Is for triptans and ergots…

Answer 12

uncontrolled HTN
pregnancy
hx of cardiovascular dz

Question 13

4 drugs for migraine prevention…

Answer 13

propranolol
amitriptyline
topiramate
CGRP antagonists (umab)

Question 14

non-throbbing, bilateral band like HA

lasts 30min to 7 days, worsens during day

rare photo/phonophobia

No N/V

Answer 14

tension HA

Question 15

What classification of TTH?

1-14days a month lasting 30 min-several days

not disabling

Answer 15

frequent

Question 16

sharp, boring unilateral periorbital pain

autonomic sx (tearing, etc)

excruciating pain

15-180 minutes

Answer 16

cluster HA

Question 17

describe the course of cluster HA

Answer 17

similar time of day/night x several weeks with remission

Question 18

Initial diagnostic imaging for cluster HA

Answer 18

MRI with and without contrast

Question 19

Acute tx of cluster HA

Answer 19

100% O2 NRB 12 L/min x 15 minutes upright

SC sumatriptan

Question 20

when to not use oxygen with cluster HA

Answer 20

severe COPD

Question 21

Preventative tx of cluster HA…

Answer 21

verapamil

Question 22

Moderate pain on sides or top of head 15+ days x 3+ months

Answer 22

chronic migrain, tension

hemicrania continua

Question 23

continuous, fluctuating pain
on same side of face/head lasting minutes to days

tearing, irritated eyes, rhinorrhea, swollen eyelids

Answer 23

hemicrania continua

Question 24

Dx and Tx of chronic daily HA…

Answer 24

indomethacin

Question 25

Abrupt onset HA and does not remit

ranges from mild to severe:
throbbing/tightening on both sides of head

Answer 25

new daily persistent HA

Question 26

new daily persistent HA Tx

Answer 26

muscle relaxants
antidepressants
anticonvulsants

Question 27

Ice pick or jabs and jolts

lasts 1-10 seconds

trigeminal distro

Answer 27

primary stabbing hx

Question 28

Imaging for primary exertional HA

Answer 28

MRI/MRA r/o vascular issue

Question 29

Tx for primary exertional HA

Answer 29

warm up

indomethacin prophylaxis

Question 30

Secondary HA

SNOOP

Answer 30

systemic sx
neurologic sx
onset sudden
older
previous HA hx

Question 31

• “Thunderclap headache”, Decreased LOC, nuchal
rigidity, first and worst HA
• CT: hemorrhage, Lumbar puncture: bloody CSF

Answer 31

SAH