headache

Question 1

made worse by foods containing tyramine (rotting foods, cheese, meat, wine, chocolate, caffeine)

Answer 1

migraine

Question 2

made worse by foods containing tyramine (rotting foods, cheese, meat, wine)

Answer 2

migraine

Question 3

obese female with papilledema (↑ICP)

Answer 3

pseudotumor cerebri or hydrocephalus

Question 4

jaw muscle pain when chewing

Answer 4

temporal arteritis (vasculitis - jaw claudication)

Question 5

periorbital pain with ptosis and miosis

Answer 5

cluster

Question 6

photophobia and/or phonophobia

Answer 6

migraine

Question 7

bilateral frontal/occipital pressure

Answer 7

tension

Question 8

using topical retinoic acid for acne

Answer 8

pseudotumor cerebri

Question 9

lacrimation and/or rhinorrhea

Answer 9

cluster

Question 10

elevated ESR

Answer 10

temporal arteritis

Question 11

headache + extraocular muscle palsies

Answer 11

cavernous sinus thrombosis (CN 3, 4,V1/V2,6)

Question 12

scintillating scatomata (visual aura) prior to headache

Answer 12

migraine with aura

Question 13

headache before or after orgasm

Answer 13

postcoital cephalogia

Question 14

responds to 100% O2

Answer 14

cluster

Question 15

trauma to head → headache begins days after event (low pressure veins), persists over a week (doesn’t go away)

Answer 15

subdural hematoma

Question 16

severe headache + fever or neck stiffness

Answer 16

meningitis

Question 17

constant headache (all day, night), progressively worsening and/or focal neuro deficits + seizures

Answer 17

brain tumor

Question 18

periorbital pain with partial horner’s (ptosis and miosis)

Answer 18

cluster

Question 19

ipsilateral eye redness, lacrimation, rhinorrhea, and/or nasal congestion

Answer 19

cluster

Question 20

scintillating scatomata (visual aura) prior to headache

Answer 20

migraine with aura (↑ risk of stroke)

Question 21

headache common in young men who smoke

Answer 21

cluster

Question 22

UNILATERAL, piercing, constant pain in retroperitoneal or periorbital area

Answer 22

cluster

Question 23

headache is daily (at same time) lasts for 15 min - 3 hrs for weeks → stops for months → returns

Answer 23

cluster

Question 24

at least 2 of:
unilateral
throbbing, pulsating
mod-severe (prohibits daily activities)
aggravated by activity (stairs)
at least 1 of:
N and/or V
photophobia and/or phonobobia

Answer 24

migraine

Question 25

is an aura a diagnostic criteria for migraine?

Answer 25

no. | aura (scintillating scotomata - light around periphery of visual field or smell)

Question 26

headaches more common in women

Answer 26

tension (by small amount) | migraine

Question 27

BILATERAL, constant in frontal or occipital region can feel like a band squeezing the head NO: photophobia, phonophobia, aura, N/V, focal neuro deficits

Answer 27

tension

Question 28

how long are migraines?

Answer 28

4 hrs - 3 days

Question 29

how long are tension headaches?

Answer 29

4-6 hrs - up to 1 week

Question 30

``` at least 2 of: unilateral throbbing, PULSATING mod-severe (prohibits daily activities) aggravated by activity (stairs) at least 1 of: N and/or V photophobia and/or phonobobia ```

Answer 30

migraine

Question 31

abortive treatment for migraine

Answer 31

NSAIDs: ibuprofen, naproxen | -triptans (sooner used - during aura or prodrome, better work)

Question 32

abortive treatment for cluster

Answer 32

fastest effect: inhaled 100% O2 -triptan NSAIDs acetaminophen

Question 33

treatment for tension

Answer 33

NSAIDs | acetaminophen

Question 34

MOA of -triptan

Answer 34

5HT agonist: vasoconstriction inhibit neurotransmission in CN 5

Question 35

contraindications of -triptans

Answer 35

``` CAD - constrict coronary vessels prinzmetal angina (vasospasms of coronary arteries) pregnancy - constrict placenta ```

Question 36

MOA of -triptan

Answer 36

5HT 1B/1D R agonist: vasoconstriction inhibit neurotransmission in CN 5

Question 37

treatment of pseudotumor cerebri

Answer 37

acetazolamide: use pseudotumor cerebri glaucoma altitude sickness