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CMN 568 - Unit 5: Questions & Solutions (Rated A+)
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CMN 568 - Unit 5: Questions & Solutions (Rated A+)
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CMN 568 - Unit 5: Questions & Solutions (Rated A+)Diminution of headache in response to typical migraine therapies (e.g.
seratonin receptor antagonists or ketorolac) does not rule out _________________
as underlying cause? Right Ans - Subarachnoid hemorrhage or meningitis
Mcphee p 39
IMMEDIATE TREATMENT: Vascular events Right Ans - + Intracranial
hemorrhage
+ Thrombosis
+ Cavernous sinus thrombosis
+ Vasculitis
+ Malignant hypertension
+ Arterial dissection
+ Aneurysm
McPhee p 39
IMMEDIATE TREATMENT: Infections Right Ans - + Abscess
+ Encephalitis
+ Meningitis
Mc Phee p 39
Causes of headache that require IMMEDIATE TREATMENT Right Ans - +
Vascular events
+ Infections
+ Intracranial masses
+ Preeclampsia
+ Carbon monoxide poisioning
McPhee p 39
"Thunderclap headache" is the classic presentation of what condition?
Right Ans - Subarachnoid hemorrhage! Should precipitate IMMEDIATE
workup!
McPhee p 39
,New headache in a patient > ________________ years or with ___________________
(condition) should warrant IMMEDIATE neuroimaging. Right Ans - + >
50years
+ HIV infection
McPhee p 39
Headache patients with hx of hypertension (esp uncontrolled htn) should be
examined for other features of WHAT? Right Ans - Malignant hypertension
McPhee p 39
Headache associated with pregnancy? Right Ans - Preeclampsia
McPhee p 39
Episodic headache associated with triad of hypertension, heart palpitations
and sweats is suggestive of __________________. Right Ans -
Pheochromocytoma
McPhee p 39
Symptoms for diagnosis or ruling out migraine in the absence of "classic"
presentation (e.g. scintillating scotomoa, unilateral ha, photophobia and n/v)?
Right Ans - Symtoms: Nausea, photophobia, phonophobia and exacerbation
with physical activtiy
THREE OR MORE = MIGRAINE
< THREE = r/o MIGRAINE
McPhee p 39
Critical components of physical exam for complaint of HA? Right Ans - +
Vital signs
+ Complete neuro exam
+ Vision testing (with funduscopic exam)
McPhee p 40
,Kernig and Brudzinski signs are indicative of what? Right Ans - Meningeal
irritation
McPhee p 40
Scalp and temporal artery tenderness should be performed on pts with HA
who are > ______________ years. Right Ans - > 60
McPhee p 40
Components of visual exam for pt presenting with HA? Right Ans - + Visual
acuity (Snellen)
+ Ocular gaze (Motor test - 9 positions)
+ Visual fields (Cover test - central/periph vision)
+ Pupillary defects (Size, dilation)
+ Optic disks
+ Retinal vein pulsations
McPhee p 40
Pt with HA and *diminished visual acuity* suggests.... Right Ans - +
Glaucoma
+ Temporal arteritis
+ Optic neuritis
McPhee p 40
Pt with HA and *ophthalmoplegia or visual field defects* suggests.... Right
Ans - + Venous sinus thrombosis
+ Tumor
+ Aneurysm
McPhee p 40
Pt with HA and *hypertension, "cotton wool spots", flame hemorrhages and
disk swelling* suggests.... Right Ans - + Acute severe hypertensive
retinopathy
, McPhee p 40
Pt with HA and *ipsilateral ptosis and miosis* suggests.... Right Ans -
Horner syndrome AND/OR carotid artery dissection
McPhee p 40
Pt with HA and *papilledema or absent retinal venous pulsations* suggests....
Right Ans - ↑ ICP
+ Follow with neuroimaging prior to performing lumbar puncture
McPhee p 40
ANY abnormality on neuro exam (esp mental status) of pt with HA warrants....
Right Ans - + EMERGENT neuroimaging
McPhee p 40
Ottawa criteria for evaluation of pts presenting with acute non-traumatic
headache for signs of subarachnoid hemorrhage Right Ans - + ≥ 40 years of
age
+ Neck pain/stiffness
+ Witnessed loss of consciousness
+ Onset during exertion
+ Thunderclap headache
+ Limited neck flexion on examination
McPhee p 41
What kind of early treatment of diagnosed migraine or migraine-like
headache can abort or provide significant relief of symptoms? Right Ans - +
NSAIDs (e.g. ketorolac)
+ Triptans
McPhee p 41
What types of headaches may respond well to high-flow O2 therapy? Right
Ans - ALL types
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