MIGRAINE Flashcards
(14 cards)
Which of the following is a characteristic feature of migraine?
A) Unilateral, throbbing headache
B) Continuous, daily headache with no associated symptoms
C) Pain in the temples with no nausea or vomiting
D) Sudden headache occurring after an exertion
Correct Answer: A) Unilateral, throbbing headache
Rationale: Migraines are typically characterized by unilateral, throbbing pain, often accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound. The pain is episodic, unlike continuous headaches.
What is the most common trigger for migraine attacks?
A) Bright lights
B) Physical exertion
C) Alcohol
D) Hormonal fluctuations
Correct Answer: A) Bright lights
Rationale: Bright lights are one of the most common environmental triggers for migraine attacks, although other triggers such as hormonal fluctuations and alcohol also play a role. Sensitivity to light is one of the hallmark features of migraines.
The premonitory phase of a migraine is also known as the:
A) Aura phase
B) Postdrome phase
C) Prodrome phase
D) Headache phase
Correct Answer: C) Prodrome phase
Rationale: The prodrome phase, also known as the premonitory phase, occurs before the onset of the headache and can include symptoms such as yawning, fatigue, mood changes, and food cravings. This phase can last hours to days.
Which of the following is true regarding the migraine aura?
A) It occurs in 50-60% of all migraine sufferers.
B) The aura phase lasts for several hours.
C) It is often associated with visual disturbances like flashing lights or zigzag lines.
D) Aura always precedes the headache phase.
Correct Answer: C) It is often associated with visual disturbances like flashing lights or zigzag lines.
Rationale: The aura phase occurs in about 20–25% of migraine sufferers and is typically marked by visual disturbances such as flashing lights or zigzag lines, though it can also involve other neurologic symptoms.
Which of the following medications is a triptan used in the acute treatment of migraines?
A) Sumatriptan
B) Propranolol
C) Topiramate
D) Gabapentin
Correct Answer: A) Sumatriptan
Rationale: Sumatriptan is a commonly used triptan for the acute treatment of migraine. It works by stimulating serotonin receptors, which help reduce pain and inflammation in the trigeminovascular system.
In which phase of a migraine attack is sensitivity to light and sound most commonly observed?
A) Premonitory (prodrome) phase
B) Headache phase
C) Postdrome phase
D) Aura phase
Correct Answer: B) Headache phase
Rationale: Sensitivity to light (photophobia) and sound (phonophobia) are hallmark symptoms of the headache phase of a migraine. These symptoms are typically not present in the prodrome or postdrome phases.
What role does calcitonin gene-related peptide (CGRP) play in the pathogenesis of migraines?
A) It is involved in promoting vasoconstriction in the brain.
B) It is released from neurons, causing inflammation and pain.
C) It suppresses neuronal activity in the trigeminal nerve.
D) It inhibits the release of serotonin in the brain.
Correct Answer: B) It is released from neurons, causing inflammation and pain.
Rationale: CGRP is a vasoactive neuropeptide that is released during a migraine attack. It plays a key role in promoting inflammation and pain by acting on the vascular and sensory pathways in the trigeminal nerve.
Which of the following is a recognized risk factor for developing chronic migraine?
A) Episodic migraine with fewer than 4 attacks per month
B) Lack of family history of migraines
C) Overuse of acute migraine medications
D) Younger age at onset of migraines
Correct Answer: C) Overuse of acute migraine medications
Rationale: Medication overuse, often involving painkillers or triptans, is a well-established risk factor for the development of chronic migraine. This phenomenon is known as medication-overuse headache.
Which gene mutation is responsible for familial hemiplegic migraine (FHM) type 1?
A) SCN1A gene
B) ATP1A2 gene
C) CACNA1A gene
D) CHRNA4 gene
Correct Answer: C) CACNA1A gene
Rationale: Mutations in the CACNA1A gene, which encodes the P/Q-type voltage-gated calcium channel, are responsible for familial hemiplegic migraine type 1 (FHM1). This mutation causes an alteration in membrane excitability that predisposes individuals to migraine attacks.
Which of the following is an example of a migraine with brainstem aura?
A) Visual disturbances with no headache
B) Sensory disturbances without motor involvement
C) Vertigo and diplopia with or without headache
D) Aura with pure speech disturbances
Correct Answer: C) Vertigo and diplopia with or without headache
Rationale: Migraine with brainstem aura involves symptoms such as vertigo, diplopia, dysarthria, or ataxia, along with or without a headache. These symptoms suggest involvement of the brainstem.
What is the role of serotonin in the pathophysiology of migraine?
A) Serotonin causes vasodilation, which worsens the headache.
B) Serotonin regulates pain through the trigeminovascular system.
C) Serotonin is involved only in the aura phase of migraine.
D) Serotonin has no role in migraine.
Correct Answer: B) Serotonin regulates pain through the trigeminovascular system.
Rationale: Serotonin (5-HT) is involved in regulating pain through the trigeminovascular system. It affects pain signaling pathways in the brainstem and modulates vasoconstriction in the cranial blood vessels, making it a key factor in the pathophysiology of migraine.
What is a common characteristic of the postdrome phase of a migraine?
A) Severe headache with vomiting
B) Feelings of tiredness and difficulty concentrating
C) Sudden improvement of migraine symptoms
D) Marked sensory hypersensitivity
Correct Answer: B) Feelings of tiredness and difficulty concentrating
Rationale: The postdrome phase is characterized by symptoms like tiredness, difficulty concentrating, and mild neck discomfort. These symptoms can last for several hours or even up to a day after the headache has subsided.
What is the term used for recurrent neurological symptoms with no associated headache in migraine?
A) Acephalgic migraine
B) Migraine with aura
C) Chronic migraine
D) Basilar-type migraine
Correct Answer: A) Acephalgic migraine
Rationale: Acephalgic migraine refers to a type of migraine where patients experience the typical aura symptoms, such as visual disturbances or other neurological signs, without a corresponding headache.
