Headache Questions
1. A 40 y/o man presents with headache, stiff neck and T 38.9 F. What is the next best step in management?
a. Do an emergent lumbar puncture
b. Order an MRI
c. Perform a lumbar puncture after a negative CT.
d. Treat him empirically with antibiotics and send him home.
e. Consult neurology
2. Which headache responds to nasal O2? [most would recommend oxygen by non-rebreather face mask, not by nasal canula]
a. Cluster headache
b. Pseudotumor cerebri
c. Migraine
d. Acute angle closure glaucoma
e. Tension headache
3. You are an emergency department attending taking care of a patient with a headache. Which patient would you most likely send for imaging?
a. 18 y/o female with unilateral headache, photophobia but no aura.
b. 45 y/o male with unilateral headache associated with ipsilateral rhinorrhea.
c. 60 y/o female with unilateral headache and jaw claudication
d. 60 y/o female with history of major depression and general anxiety disorder who presents with altered mental status and severe headache.
e. 70 y/o male with general anxiety disorder and severe bilateral headache.
4. You are in clinic when a 45 y/o man presents with 2 months history of bilateral throbbing headaches. He has a past medical history of low back, hypertension, and hypothyroidism. What is a likely cause of his headache?
a. Cluster headache
b. NSAID overuse headache
c. Pseudotumor cerebri
d. Subarachnoid hemorrhage
e. Post traumatic headache
5. A 20 y/o female presents to you with frontal throbbing headache, constant pounding in her ears, and mild rhinorrhea. Which intervention would be of most benefit to her?
a. Ibuprofen and an antihistamine
b. Lumbar puncture
c. Transcranial Doppler
d. Nasal O2
e. Sumatriptan
6. An 80 y/o male has been admitted for a subarachnoid hemorrhage. Which complication is most likely to occur in the first 24 hours?
a. Hydrocephalus
b. Ischemic stroke
c. Vasospasm
d. Rebleeding
e. Pulmonary embolus
7. Which is a risk factor for an infectious cause of headache?
a. Cold weather
b. Recent pneumonia
c. Recent subarachnoid hemorrhage
d. Neck trauma
e. Hypoxia
8. A 16 y/o boy presents to the ED with myalgias, fatigue, headache, and flushing. He recently went swimming in a indoor pool with heating system. His two younger sibling are also in the ED for similar complaints. What is the next best step in management?
a. Do a workup for MEN I.
b. Discharge home with a diagnosis of the flu.
c. Start him on oxygen and get a carbon monoxide level
d. Get a urine tox screen for drug use
e. Get a CT scan
9. A 53 y/o female presents with headache, blurred vision and jaw claudication. What other complaints will likely be improved with steroid treatment?
a. Aching and stiffness of neck, shoulders, and hip girgles
b. Stress incontinence
c. Peptic ulcer
d. Osteoporosis
a. Anxiety
10. Which patient’s headache should improve with sumatriptan therapy?
a. 11 y/o male with new onset ataxia
b. 70 y/o female with new onset headache and blurry vision
c. 25 y/o female with obesity and blurry vision
d. 35 y/o male with sinus tenderness and a fever
e. 45 y/o female with bilateral headache, aura, photophobia, and nausea/vomiting.