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Headache – Assessment (PG)
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1. Which red flag feature in a headache history may indicate a serious underlying cause?
*
A. Bilateral dull ache
Sudden onset "thunderclap"
Gradual worsening over months
Stress association
2. What is the most appropriate initial step in evaluating a new onset headache in an adult?
*
Prescribe triptans
Refer directly for CT scan
Detailed history and examination
Prescribe opiates
3. Which symptom is most associated with raised intracranial pressure?
*
Nausea without headache
Jaw claudication
C. Headache worse on waking or coughing
Photophobia only
4. Which of the following would most urgently warrant neuroimaging?
*
Migraine in patient with history
Episodic tension-type headache
Headache worse in afternoon
New focal neurological deficit
5. What is a key feature of temporal arteritis-related headache?
*
Jaw claudication
Frontal throbbing
Vertigo
Exacerbated by exertion
6. Which finding is most suggestive of a brain tumour as a headache cause?
*
Worse during exercise
Sharp pain
New seizure or focal signs
Associated sinus congestion
7. In cluster headache, the pain typically occurs:
*
Diffusely and bilaterally
Only in response to stress
After heavy meals
Unilaterally around the eye with autonomic features
8. What feature differentiates migraine from other primary headaches?
*
No associated symptoms
Aura, nausea, photophobia
Always bilateral
Pain worsens when lying down
9. Which of the following is NOT a typical red flag in headache assessment?
*
Headache in immunosuppressed patient
Headache with fever and neck stiffness
New headache in patient over 50
Headache after physical activity
10. What examination finding might suggest meningitis?
*
Neck stiffness and photophobia
Dizziness
Dry skin
Jaw tenderness only
11. When is urgent CT head indicated?
*
Tension-type headache
New thunderclap headache
Migraine in known history
Stress-related headache
12. Which of these is a feature of subarachnoid haemorrhage?
*
Sudden severe occipital headache
Gradual worsening over days
Isolated nausea
Dull bilateral pressure
13. What feature may suggest benign intracranial hypertension?
*
Headache improves lying down
Visual disturbance and papilloedema
Unilateral tearing
Sinus pressure
14. What cranial nerve palsy may suggest raised ICP or tumour?
*
CN-VII
CN-V
CN-VI
CN-XII
15. Which systemic condition may cause headache as a secondary symptom?
*
Hypertension
Asthma
Psoriasis
Vitiligo
16. Which is the 5th Cranial nerve (CN-V)
*
Facial nerve
Vagus nerve
Trigeminal nerve
Glosopharyngeal nerve
17. What does the "A" represent in a DANISH assessment?
*
Aura
Ataxia
Aphasia
Arthralgia
18. When is ESR useful in headache evaluation?
*
Suspected giant cell arteritis
Migraine
Sinusitis
Cluster headache
19. Which test helps confirm diagnosis of meningitis?
*
ABPI
Lumbar puncture
Doppler
ANA
20. Which feature requires referral for suspected space-occupying lesion?
*
Tension-type headache
New seizures
Mild intermittent headaches
Red watery eye