Neurology

Question 1

what is the primary difference in the medication effect between triptants and gepants/ditans?

Answer 1

gepants and ditans do not cause vascular constriction / have vascular contraindications

Question 2

what is the first line treatment for acute treatment of mild to moderate migraine?

Answer 2

nsaids

Question 3

what is the first line abortive treatment for moderate to severe migraine?

Answer 3

triptan

Question 4

if a patient fails their first trial of triptan medication, what is the next step in abortive treatment?

Answer 4

try another triptan

Question 5

what does the POUND pneumonic stand for in the diagnosis of migraine?

Answer 5

P - pulsatile
O - one day duration
U - unilateral
N - nausea / vomiting
D - disabling

Question 6

over what age serves as a potential red flag for new onset or changing headache?

Answer 6

> 50 years old

Question 7

t/f aspartame has been linked to migraine trigger

Answer 7

true

Question 8

what validated questionnaire should you use to assess migraine severity?

Answer 8

migraine disability assessment

Question 9

what questionnaire can be used to assess treatment response in migraine and guide the need for escalation of therapy?

Answer 9

migraine treatment optimization questionnaire

Question 10

how is medication overuse headache defined in terms of the number of days that abortive therapy is taken?

Answer 10

10 or more days per month of abortive treatment

Question 11

in the acute treatment of migraine, what medication class can cause chest discomfort, flushing, sweating, nausea and vomiting?

Answer 11

triptan

Question 12

t/f lasmiditan (reyvow) can cause dizziness, somnolence, sserotonin syndrome, has black box warning, cannot drive for 8 hours following dose and is a schedule V drug

Answer 12

true

Question 13

when can a dose of triptan be repeated if migraine is still ongoing?

Answer 13

after 2 hours

Question 14

what is the mechanism of action of gepants such as ubrelvy and nurtec?

Answer 14

calcitonin gene related peptide receptor anatgonists

Question 15

why is atogepant different than the other cGRP receptor antagonists?

Answer 15

it is approved for prevention only

Question 16

what is the mechanism of action of ditan medications?

Answer 16

5HT1 receptor agonists - prevent cGRP release from the trigeminal nerve

Question 17

which class of medications should be used to address the nausea component in acute migraine?

Answer 17

dopamine antagonists

Question 18

t/f zofran has insufficient evidence in the treatment of nausea during acute migraine

Answer 18

true

Question 19

what is the definition of satus migranosus?

Answer 19

migraine lasting > 72 hours

Question 20

t/f greater occipital nerve block can result in pain improvement in acute migraine

Answer 20

true

Question 21

t/f gepants and ditans have not been approved for use in children

Answer 21

true

Question 22

which triptan has been approved for use in children 6 and older?

Answer 22

rizatriptan

Question 23

what is the first line abortive treatment for migraine during pregnancy?

Answer 23

APAP-caffeine combination

Question 24

what medication is the recommended second line agent for migraine acute treatment during pregnancy?

Answer 24

metoclopramide

Question 25

t/f for breastfeeding mothers, acetaminophen, nsaids excluding ASA, caffeine and metoclopramide are considered appropriate interventions for acute migraine

Answer 25

true

Question 26

what are two cGRP medications that can be used to treat acute migraine?

Answer 26

Ubrelvy and Nurtec

Question 27

which class of medication has been shown to be the most effective in the treatment for acute migraine?

Answer 27

triptan

Question 28

acute migraine symptoms are classified according to what scoring system?

Answer 28

MIDAS

Question 29

t/f ditan medications can lead to overuse headache

Answer 29

true

Question 30

which class of abortive migraine medication has a black box warning for impaired driving and somnolence 8 hours following dosing?

Answer 30

lasmitidan