Headache

Question 1

what type(s) of headaches have bilateral localization?

Answer 1

tension type

Question 2

what type(s) of headaches have unilateral localization?

Answer 2

migraine
cluster

Question 3

what type of headache is a constant pain lasting 4-6 hrs?

Answer 3

tension-type

Question 4

what type of headache lasts 4-72 hrs?

Answer 4

migraine

Question 5

what type of headache lasts 1.5-3 hrs and is repetitive?

Answer 5

cluster

Question 6

what type of headache is characterized by steady “band-like” pain?

Answer 6

tension

Question 7

what type of headache is characterized by pulsating pain with nausea, photophobia, and/or phonophobia?

Answer 7

migraine

Question 8

what type of headache is characterized by excruciating periorbital pain with autonomic symptoms?

Answer 8

cluster

(lacrimation, rhinorrhea, conjuctival injection)

Question 9

what type of headache may present with Horner’s syndrome?

Answer 9

cluster

Question 10

what type of headache is present with either photophobia or phonophobia?

(not both)

Answer 10

tension

Question 11

what type of headache is the most common primary headache?

Answer 11

tension

Question 12

what type of headache(s) are more common in females?

Answer 12

migraine
tension-type

Question 13

what type of headache(s) are more common in males?

Answer 13

cluster

Question 14

MOA of triptans

Answer 14

5-HT1 agonists
inhibit trigeminal nerve activation, prevent VIP release, induce vasoconstriction

Question 15

classic triad of opioid overdose

Answer 15

miosis
AMS
respiratory depression

(others: seizures, constipation, nausea, bradycardia, hypotension, hypothermia)

Question 16

mu receptor antagonist for opioid overdose

Answer 16

naloxone

Question 17

what acid-base disorder does ethylene glycol cause?

Answer 17

metabolic acidosis with anion gap

Question 18

calculation for anion gap

Answer 18

[Na+] - ([Cl-] + [HCO3-])

Question 19

what kind of acid-base disorder do opioids cause?

Answer 19

respiratory acidosis (hypoventilation)

Question 20

what is a normal anion gap?

Answer 20

8-12

Question 21

the most commonly involved junction for berry aneurysm to occur is between the anterior communicating artery and […]

Answer 21

ACA

Question 22

Account for approx. 80% of cases of nontraumatic subarachnoid hemorrhage

Answer 22

berry aneurysm

Question 23

What congenital conditions predispose individuals to developing berry aneurysms?

Answer 23

autosomal dominant PCKD
Ehlers-Danlos
Marfans
aortic coarctation

Question 24

the mass effect from an aneurysm in the […] can cause bitemporal hemianopia and visual acuity defects

Answer 24

ACA

(visual acuity defects from compression of CN II at the optic chiasm)

Question 25

the mass effect from an aneurysm in the [...] can cause mydriasis via compression of CN III

Answer 25

PCA ptosis if compression is severe (parasympathetic fibers are on the periphery, and compressed first)

Question 26

mass lesions affecting CN III will effect the [...] fibers first

Answer 26

parasympathetic (results in dilated pupil, unable to constrict) (classically PCA aneurysm)

Question 27

what motor signs would you expect to see with a CN III palsy?

Answer 27

"down and out" eye ptosis (classically associated with uncal herniation)

Question 28

a lesion in the MLF results in

Answer 28

intranuclear ophthalmoplegia (classically associated with MS; MLF in MS)

Question 29

Intranuclear ophthalmoplegia manifests primarily with impaired adduction of the eye [...] to the lesion

Answer 29

ipsilateral (INO= Ipsilateral adduction failure, Nystagmus Opposite)

Question 30

Intranuclear ophthalmoplegia manifests primarily with nystagmus of the eye [...] to the lesion

Answer 30

contralateral (INO= Ipsilateral adduction failure, Nystagmus Opposite)

Question 31

in the MLS: when looking left, the left nucleus of CN VI fires, which contracts the [...] muscle and stimulates the contralateral nucleus of CN III to contract the [...] muscle

Answer 31

lateral rectus medial rectus

Question 32

most common cause of neuroleptic malignant syndrome (NMS)

Answer 32

high potency (typical) anti-psychotics (haloperidol, fluphenazine, and flupentixol)

Question 33

treatment for neuroleptic malignant syndrome

Answer 33

dantrolene (inhibits ryanodine receptor)

Question 34

Metoclopramide may cause [...] syndrome

Answer 34

neuroleptic malignant

Question 35

The symptoms of neuroleptic malignant syndrome may be remembered with the mnemonic Malignant FEVER

Answer 35

Myoglobinuria Fever Encephalopathy unstable Vitals Enzymes (CK) Rigidity