TTH Flashcards
Which of the following is the most distinguishing clinical feature of tension-type headache (TTH) compared to migraine?
A) Nausea
B) Phonophobia
C) Throbbing pain
D) Bilateral tight, bandlike discomfort
Answer: D) Bilateral tight, bandlike discomfort
Rationale: TTH is characterized by bilateral tight, bandlike discomfort, which differentiates it from migraines, which are typically associated with throbbing pain and unilateral location. TTH headaches do not generally include accompanying features such as nausea, photophobia, or phonophobia.
Which of the following treatments is the only one proven to be effective for chronic tension-type headache (TTH)?
A) Acetaminophen
B) Onabotulinum toxin type A
C) Amitriptyline
D) Behavioral therapy
Answer: C) Amitriptyline
Rationale: Amitriptyline, a tricyclic antidepressant, is the only proven treatment for chronic TTH. Other medications such as tricyclics, SSRIs, and benzodiazepines have not been shown to be effective in treating chronic TTH.
Tension-type headaches (TTH) are most commonly characterized by all of the following EXCEPT:
A) Slow onset and fluctuating severity
B) Pain aggravated by movement
C) Bilateral tight, bandlike discomfort
D) Associated nausea and vomiting
Answer: D) Associated nausea and vomiting
Rationale: TTH typically lacks associated features such as nausea, vomiting, photophobia, phonophobia, or throbbing pain. These features are more characteristic of migraines. TTH presents with bilateral, tight, bandlike discomfort, and pain that fluctuates in severity without aggravation by movement.
Which of the following best describes the pathophysiology of tension-type headache (TTH)?
A) A generalized disturbance of sensory modulation
B) A primary disorder of central nervous system pain modulation
C) Increased muscle contraction leading to pain
D) An inflammatory process affecting the trigeminal nerve
Answer: B) A primary disorder of central nervous system pain modulation
Rationale: TTH is thought to be due to a primary disorder of central nervous system pain modulation, unlike migraines, which involve a more generalized disturbance of sensory modulation. Muscle contraction has not been shown to be a primary cause of TTH pain, as no differences in muscle contraction between TTH and migraines have been found.
Which of the following treatments is NOT effective for tension-type headache (TTH)?
A) Simple analgesics (acetaminophen, aspirin, NSAIDs)
B) Triptans
C) Relaxation therapy
D) Behavioral approaches
Answer: B) Triptans
Rationale: Triptans are not effective in treating pure TTH. However, they may be helpful when the patient has both TTH and migraine. Simple analgesics and behavioral approaches like relaxation therapy are more commonly effective in managing TTH.
Tension-type headaches are most likely to be diagnosed in which of the following situations?
A) Headaches with nausea, vomiting, and photophobia
B) Episodic headaches with bilateral pain and no associated features
C) Chronic unilateral throbbing pain
D) Headaches associated with visual aura and sensitivity to light
Answer: B) Episodic headaches with bilateral pain and no associated features
Rationale: TTH is diagnosed when headaches are characterized by bilateral, tight, bandlike discomfort without accompanying features such as nausea, vomiting, photophobia, or throbbing pain. Migraines, on the other hand, tend to have these features and are usually unilateral.
