Unit 2: Headache

Question 1

L1: What agent is used for migraine prophylaxis for patients with chronic migraine?

Answer 1

Botox

Question 2

L1: What is the treatment for termination of mild-moderate migraines?

Answer 2

NSAIDs

Question 3

L1: Which cause of headache? Associated with fever, neck stiffness, and other constitutional symptoms

Answer 3

Meningitis

Question 4

L1: Which cause of headache? Worst headache of life with diffuse pain

Answer 4

Subarachnoid hemorrhage

Question 5

L2: What agent is used for migraine prophylaxis in other countries by 5-HT2 antagonism?

Answer 5

Methysergide

Question 6

L2: What agents are used for short-term migraine prophylaxis?

Answer 6

NSAIDs

Question 7

L2: What are two drugs classified as ergot alkaloids?

Answer 7

Ergotamine, dihydroergotamine

Question 8

L2: What are two drugs classified as triptans?

Answer 8

Sumatriptan, Zolmitriptan

Question 9

L2: What is the mechanism of action for triptans and ergot alkaloids?

Answer 9

5-HT1 receptor agonists

Question 10

L2: What is the treatment for termiantion of migraines that do not adequately respond to 5-HT agonists?

Answer 10

Opioids (Tramadol)

Question 11

L2: Which cause of headache? Secondary headache associated with jaw claudication, temproal artery region scalp tenderness, blindness, and constitutional symptoms

Answer 11

Giant Cell Arteritis

Question 12

L2: Which type of headache? Intense, sharp, superficial, or stabbing pain lasting up to two minutes

Answer 12

Trigeminal Neuralgia

Question 13

L2: Which type of headache? Periorbital or temporal pain

Answer 13

Cluster Headache

Question 14

L3: Name 4 characteristic features of migraines.

Answer 14

Unilateral, pulsating, moderate-severe intensity, pain increases with physical activity

Question 15

L3: Name associated features of migraines.

Answer 15

Nausea/vomiting, photophobia/phonophobia

Question 16

L3: What are first line agents for migraine prophylaxis? (2)

Answer 16

Beta-Blockers, anticonvulsants (valproate, topiramate)

Question 17

L3: What are second line agents for migraine prophylaxis? (2)

Answer 17

Antidepressants, ACEIs

Question 18

L3: What are the most serious side effects of ergot alkaloids not present with triptans

Answer 18

Vascular occlusion, gangrene

Question 19

L3: What are third line agents for migraine prophylaxis? (2)

Answer 19

Calcium channel blockers, anticonvulsant Gabapentin

Question 20

L3: What is the treatment for termination of migraines that are refractory to first line treatment? (3)

Answer 20

Triptans, dihydroergotamine, ergotamine

Question 21

L4: What are contraindications for triptans?

Answer 21

Coronary artery disease, cerebrovascular disease, arterial disease, or uncontrolled hypertension