OTHER PRIMARY HEADACHE Flashcards
What is the hallmark feature of primary cough headache?
A) Bilateral headache with throbbing pain
B) Sudden onset of generalized headache precipitated by coughing
C) Pain that lasts for more than 24 hours
D) Headache that improves with physical activity
Correct Answer: B) Sudden onset of generalized headache precipitated by coughing
Rationale: Primary cough headache is characterized by sudden, brief onset of headache triggered by coughing, sneezing, straining, laughing, or stooping.
Which of the following conditions must be excluded before diagnosing primary cough headache?
A) Tension-type headache
B) Cerebral aneurysm and Chiari malformation
C) Cluster headache
D) Occipital neuralgia
Correct Answer: B) Cerebral aneurysm and Chiari malformation
Rationale: Before diagnosing primary cough headache, it is important to exclude serious underlying conditions such as cerebral aneurysms, Chiari malformations, or lesions that obstruct cerebrospinal fluid (CSF) pathways or displace cerebral structures.
What is the first-line treatment for primary cough headache?
A) High-dose corticosteroids
B) Indomethacin 25–50 mg two to three times daily
C) Triptans
D) Beta-blockers
Correct Answer: B) Indomethacin 25–50 mg two to three times daily
Rationale: The treatment of choice for primary cough headache is indomethacin, which is effective for preventing the headache attacks in most cases.
In some patients with primary cough headache, which alternative treatment may provide relief?
A) Lumbar puncture
B) Surgical resection of the trigeminal nerve
C) Botox injections
D) Acetaminophen
Correct Answer: A) Lumbar puncture
Rationale: Some patients with primary cough headache may experience relief from their symptoms following a lumbar puncture, though the exact mechanism of this response is unclear. This option can be more effective than long-term use of indomethacin.
Which of the following is a characteristic feature of primary exercise headache?
A) Unilateral pain with a sharp stabbing quality
B) Pain that lasts longer than 48 hours
C) Bilateral, throbbing pain often resembling migraine
D) Pain that improves with physical exertion
Correct Answer: C) Bilateral, throbbing pain often resembling migraine
Rationale: Primary exercise headache is typically characterized by bilateral, throbbing pain that can resemble migraine. This quality, along with its association with exercise, helps distinguish it from other types of headaches.
What is the treatment of choice for primary exercise headache?
A) High-dose corticosteroids
B) Indomethacin (25–150 mg daily)
C) Antidepressants
D) Triptans
Correct Answer: B) Indomethacin (25–150 mg daily)
Rationale: Indomethacin is the treatment of choice for primary exercise headache and has been shown to be effective in managing symptoms at doses ranging from 25–150 mg daily.
Which of the following treatments can be used for patients with recurrent primary sex headache?
A) High-dose corticosteroids
B) Propranolol
C) Ergotamine
D) Opioids
Correct Answer: B) Propranolol
Rationale: Propranolol, a beta-blocker, is commonly used to prevent recurrent primary sex headaches. It helps reduce the frequency and intensity of headaches when they occur regularly. The dosage typically ranges from 40–200 mg/day.
Which of the following is true about the course of primary sex headache in many patients?
A) It always leads to chronic daily headache.
B) It tends to subside within 6 months in about half of patients.
C) It requires lifelong medication for management.
D) It is typically associated with high blood pressure.
Correct Answer: B) It tends to subside within 6 months in about half of patients.
Rationale: In many patients, primary sex headache will subside within 6 months, often without the need for long-term treatment. This is particularly true for infrequent or irregular occurrences.
