[MCQ] Headache- Part 1

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Headache- Part 1

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Question 1

Which cranial structure is pain-insensitive ?

A	Scalp
B	Choroid plexus
C	Dural sinuses
D	Falx cerebri

Question 2

Which cranial structure is pain-sensitive ?

A	Ventricular ependyma
B	Choroid plexus
C	Pial veins
D	Falx cerebri

Question 2 Explanation:

Pain-producing cranial structures include scalp, middle meningeal artery, dural sinuses, falx cerebri and proximal segments of large pial arteries. Ventricular ependyma, choroid plexus, pial veins, and much of the brain parenchyma are not pain-producing.

Question 3

Which of the following is a type of primary headache ?

A	Migraine
B	Tension-type
C	Cluster
D	All of the above

Question 4

Which of the following is not a type of primary headache ?

A	Idiopathic stabbing
B	Exertional
C	Systemic infection
D	Tension-type

Question 4 Explanation:

Primary headaches are those in which headache and its associated features are the disorder in itself, whereas secondary headaches are those caused by exogenous disorders. Examples of primary headache are migraine, tension-type, cluster, idiopathic stabbing & exertional. Examples of secondary headache are systemic infection, head injury, vascular disorders, subarachnoid hemorrhage & brain tumor.

Question 5

Of the following cause of primary headache, which one is the most common ?

A	Migraine
B	Tension-type
C	Cluster
D	Exertional

Question 6

Of the following cause of secondary headache, which one is the most common ?

A	Systemic infection
B	Vascular disorders
C	Subarachnoid hemorrhage
D	Brain tumor

Question 6 Explanation:

Relative frequency of various types of secondary headache is systemic infection 63%, head injury 4%, vascular disorders 1%, subarachnoid hemorrhage <1% and brain tumor 0.1%.

Question 7

Which of the following is not a vascular headache ?

A	Migraine
B	Cluster headache
C	Tension-type headache
D	None of the above

Question 7 Explanation:

Migraine & other primary headache types are not vascular headaches

Question 8

Vomiting that precedes the appearance of headache by weeks is highly characteristic of ?

A	Meningitis
B	Subarachnoid hemorrhage
C	Posterior fossa brain tumors
D	Temporal arteritis

Question 8 Explanation:

Vomiting that precedes appearance of headache by weeks is highly characteristic of posterior fossa brain tumors.

Question 9

Migraine activators include all except ?

A	Red wine
B	Menstruation
C	Pregnancy
D	Lack of sleep

Question 10

Migraine deactivators include all except ?

A	Sleep
B	Pregnancy
C	Exhiliration
D	Hunger

Question 10 Explanation:

Activators of migraine are referred to as triggers. These include glare, bright lights, sounds, or other afferent stimulation; hunger, excess stress, physical exertion, stormy weather or barometric pressure changes, hormonal fluctuations during menses, lack of or excess sleep & alcohol or other chemical stimulation

Question 11

Triptans are least potent agonist of ?

A	5-HT1A receptor
B	5-HT1B receptor
C	5-HT1D receptor
D	5-HT1F receptor

Question 11 Explanation:

Triptans are potent agonists of 5-HT1B, 5-HT1D, and 5-HT1F receptors and are less potent at the 5- HT1A receptor.

Question 12

Antimigraine efficacy of the triptans is due to their ability to stimulate ?

A	5-HT1A receptors
B	5-HT1B receptors
C	5-HT1C receptors
D	5-HT1E receptors

Question 13

Which of the following gene has been incriminated in the causation of migraine ?

A	tRNALeu(UUR)
B	CACNL 1A4
C	DRD2
D	All of the above

Question 14

Which of the following gene has been incriminated in the causation of Familial hemiplegic migraine (FHM) ?

A	tRNALeu(UUR)
B	CACNA1A
C	DRD2
D	All of the above

Question 14 Explanation:

Mutations involving the Cav2.1 (P/Q) type voltage-gated calcium channel CACNA1A gene cause familial hemiplegic migraine 1 (FHM 1). Mutations in Na+-K+ATPase ATP1A2 gene causes FHM 2. Mutations in neuronal voltage-gated sodium channel SCN1A cause FHM 3.

Question 15

In acephalgic migraine, which of the following is least prominent?

A	Recurrent neurologic symptoms
B	Nausea or vomiting
C	Headache
D	Vertigo

Question 15 Explanation:

Patients with acephalgic migraine have recurrent neurologic symptoms, with nausea or vomiting, but with little or no headache. Vertigo may be prominent.

Question 16

MIDAS stands for ?

A	Migraine Disease Assessment Score
B	Migraine Disability Assessment Score
C	Migraine Drug Assessment Score
D	Migraine Diagnosis Assessment Score

Question 16 Explanation:

MIDAS stands for Migraine Disability Assessment Score meant to assess the extent of a patient’s disease and disability.

Question 17

Drugs effective in treatment of migraine are ?

A	Anti-inflammatory agents
B	5HT1B/1D receptor agonists
C	Dopamine receptor antagonists
D	All of the above

Question 17 Explanation:

Drugs effective in the treatment of migraine are anti-inflammatory agents, 5HT1B/1D receptor agonists and dopamine receptor antagonists.

Question 18

Electrical stimulation of which part of brain results in migrainelike headache ?

A	Temporal lobe
B	Midbrain in the region of dorsal raphe
C	Putamen
D	Globus pallidum

Question 19

Headaches that build up over hours, maintained for several hours to days, relieved by sleep are sugestive of ?

A	Migraine
B	Cluster headache
C	Brain tumors
D	Unruptured aneurysms

Question 20

Chronic head-pain syndrome best relates to ?

A	Migraine
B	Tension-type headache (TTH)
C	Cluster headache
D	All of the above

Question 20 Explanation:

Term tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, bandlike discomfort.

Question 21

Which of the following is an accompanying feature of tensiontype headache ?

A	Nausea, vomiting
B	Photophobia, phonophobia
C	Aggravation with movement
D	None of the above

Question 21 Explanation:

TTH patients have headaches without accompanying features like nausea, vomiting, photophobia, phonophobia, osmophobia, throbbing & aggravation with movement

Question 22

For chronic TTH, which is the only proven treatment ?

A	Amitriptyline
B	Selective serotonin reuptake inhibitors
C	Benzodiazepines
D	Acupuncture

Question 22 Explanation:

For chronic TTH, amitriptyline is the only proven treatment.

Question 23

Trigeminal autonomic cephalalgias include all except ?

A	Cluster headache
B	Migraine
C	Paroxysmal hemicrania
D	SUNCT

Question 23 Explanation:

Trigeminal autonomic cephalalgias (TACs) includes cluster headache, paroxysmal hemicrania & SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection & tearing). TAC features are short-lasting attacks of head pain with cranial autonomic symptoms (lacrimation, conjunctival injection, or nasal congestion).

Question 24

Short-lasting headaches without prominent cranial autonomic syndromes include ?

A	Trigeminal neuralgia
B	Primary stabbing headache
C	Hypnic headache
D	All of the above

Question 24 Explanation:

Short-lasting headaches without prominent cranial autonomic syndromes are trigeminal neuralgia, primary stabbing headache & hypnic headache.

Question 25

Which of the following is false about cluster headache ?

A	Men are affected more than women
B	Ipsilateral autonomic features
C	Propranolol and amitriptyline are ineffective
D	Lithium is not beneficial

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Headache- Part 1| Headache- Part 2

1 Which cranial structure is pain-insensitive ?
A. Scalp
B. Choroid plexus
C. Dural sinuses
D. Falx cerebri
2 Which cranial structure is pain-sensitive ?
A. Ventricular ependyma
B. Choroid plexus
C. Pial veins
D. Falx cerebri

3 Which of the following is a type of primary headache ?
A. Migraine
B. Tension-type
C. Cluster
D. All of the above
4 Which of the following is not a type of primary headache ?
A. Idiopathic stabbing
B. Exertional
C. Systemic infection
D. Tension-type

5 Of the following cause of primary headache, which one is the
most common ?
A. Migraine
B. Tension-type
C. Cluster
D. Exertional

6 Of the following cause of secondary headache, which one is the
most common ?
A. Systemic infection
B. Vascular disorders
C. Subarachnoid hemorrhage
D. Brain tumor

7 Which of the following is not a vascular headache ?
A. Migraine
B. Cluster headache
C. Tension-type headache
D. None of the above

8 Vomiting that precedes the appearance of headache by weeks is
highly characteristic of ?
A. Meningitis
B. Subarachnoid hemorrhage
C. Posterior fossa brain tumors
D. Temporal arteritis

9 Migraine activators include all except ?
A. Red wine
B. Menstruation
C. Pregnancy
D. Lack of sleep
10 Migraine deactivators include all except ?
A. Sleep
B. Pregnancy
C. Exhiliration
D. Hunger

11 Triptans are least potent agonist of ?
A. 5-HT1A receptor
B. 5-HT1B receptor
C. 5-HT1D receptor
D. 5-HT1F receptor

12 Antimigraine efficacy of the triptans is due to their ability to
stimulate ?
A. 5-HT1A receptors
B. 5-HT1B receptors
C. 5-HT1C receptors
D. 5-HT1E receptors

13 Which of the following gene has been incriminated in the causation
of migraine ?
A. tRNALeu(UUR)
B. CACNL 1A4
C. DRD2
D. All of the above
14 Which of the following gene has been incriminated in the causation
of Familial hemiplegic migraine (FHM) ?
A. tRNALeu(UUR)
B. CACNA1A
C. DRD2
D. All of the above

15 In acephalgic migraine, which of the following is least prominent?
A. Recurrent neurologic symptoms
B. Nausea or vomiting
C. Headache
D. Vertigo

16 MIDAS stands for ?
A. Migraine Disease Assessment Score
B. Migraine Disability Assessment Score
C. Migraine Drug Assessment Score
D. Migraine Diagnosis Assessment Score

17 Drugs effective in treatment of migraine are ?
A. Anti-inflammatory agents
B. 5HT1B/1D receptor agonists
C. Dopamine receptor antagonists
D. All of the above

18 Electrical stimulation of which part of brain results in migrainelike
headache ?
A. Temporal lobe
B. Midbrain in the region of dorsal raphe
C. Putamen
D. Globus pallidum
19 Headaches that build up over hours, maintained for several hours
to days, relieved by sleep are sugestive of ?
A. Migraine
B. Cluster headache
C. Brain tumors
D. Unruptured aneurysms
20 Chronic head-pain syndrome best relates to ?
A. Migraine
B. Tension-type headache (TTH)
C. Cluster headache
D. All of the above

21Which of the following is an accompanying feature of tensiontype
headache ?
A. Nausea, vomiting
B. Photophobia, phonophobia
C. Aggravation with movement
D. None of the above

22 For chronic TTH, which is the only proven treatment ?
A. Amitriptyline
B. Selective serotonin reuptake inhibitors
C. Benzodiazepines
D. Acupuncture
23 Trigeminal autonomic cephalalgias include all except ?
A. Cluster headache
B. Migraine
C. Paroxysmal hemicrania
D. SUNCT

24 Short-lasting headaches without prominent cranial autonomic
syndromes include ?
A. Trigeminal neuralgia
B. Primary stabbing headache
C. Hypnic headache
D. All of the above

25 Which of the following is false about cluster headache ?
A. Men are affected more than women
B. Ipsilateral autonomic features
C. Propranolol and amitripty

D. Lithium is not beneficial

Headache

[MCQ] Headache- Part 1

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Headache- Part 1

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