Headache

Question 1

Abortive treatment of choice for Migraines

Answer 1

Triptans

Question 2

What are Triptans

Answer 2

5HT receptor agonist, they constrict the blood vessels

Question 3

Triptans are contraindicated in?

Answer 3

Patients of Ischemic heart disease or cerebrovascular disease

Question 4

Migraine preventative therapy of choice for children?

Answer 4

Cyproheptadine

Question 5

Migraine preventative therapy of choice generally

Answer 5

Propranolol/verampil as they are antihypertensives.

Question 6

Tension-type headache treatment

Answer 6

Lifestyle modification and a triad of analgesics, antidepressants and muscle relaxants

Question 7

So what abortive therapy do we give cardiac patients?

Answer 7

Ergots, like dihydroergotamine. Considered more effective with fewer side effects than ergotamine.

Question 9

What is the character or like, what do cluster headaches feel like?

Answer 9

Stabbing, excruciating, as if their eye is being pushed out

Question 10

Abortive therapy for Cluster headaches?

Answer 10

Oxygen mask and corticosteroids.

Question 11

What is the aura of migraines with aura?

Answer 11

Flashing lights before headache begins

Question 12

A 35-year-old man presents with excruciating, strictly unilateral retro-orbital pain that peaks within 15 minutes, accompanied by ipsilateral lacrimation and nasal congestion. These episodes occur in clusters, with 1-2 attacks per day for the past 6 weeks. Which of the following is the most appropriate acute abortive therapy?
a) Oral Sumatriptan
b) High-flow oxygen via face mask
c) Amitriptyline
d) Intravenous Sodium Valproate

Answer 12

High-flow oxygen via face mask

Question 13

The most widely accepted pathophysiological theory for migraine is the:
a) Vascular Theory
b) Muscle Contraction Theory
c) Neurovascular Theory
d) Serotonin Depletion Theory

Answer 13

Neurovascular theory

Question 14

A 30-year-old woman with a history of migraine without aura wishes to start preventive therapy. She has no other medical conditions. Which of the following is a first-line pharmacologic option for migraine prevention?
a) Propranolol
b) Ergotamine
c) Cyproheptadine
d) Metoclopramide

Answer 14

Propranolol

Question 15

Which of the following characteristics is most typical of a tension-type headache?
a) Unilateral, throbbing pain
b) Pain accompanied by nausea and vomiting
c) Bilateral, pressing or tightening quality
d) Pain associated with conjunctival injection and ptosis

Answer 15

Bilateral, pressing, or tightening quality

Question 16

Which of the following preventive medications is considered the drug of choice for episodic migraine prevention according to the document?
a) Amitriptyline
b) Propranolol
c) Verapamil
d) Topiramate

Answer 16

Topiramate

Question 17

A 50-year-old man with a known brain tumor presents with a headache that is worse upon awakening and is aggravated by coughing or sneezing. This pattern is most suggestive of:
a) Migraine
b) Idiopathic Intracranial Hypertension
c) Headache due to raised intracranial pressure
d) Cluster Headache

Answer 17

Due to raised ICP

Question 18

A 40-year-old woman presents with a headache that she describes as a tight band around her head. The pain is constant and not associated with nausea or photophobia. She has been under significant stress at work. The most likely diagnosis is:
a) Migraine without Aura
b) Tension-Type Headache
c) Cluster Headache
d) Paroxysmal Hemicrania

Answer 18

Tension-type headache

Question 19

For which type of primary headache is verapamil a commonly used preventive medication?
a) Migraine with Aura
b) Tension-Type Headache
c) Cluster Headache
d) Hypnic Headache

Answer 19

Cluster headache