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D118 Neuroendocrine, Fitzgerald (New) 2023.
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D118 Neuroendocrine, Fitzgerald (New)2023
c. VII - You examine a 29 y/o female who has a sudden onset of rt-sided facial
asymmetry. She is unable to close her rt eyelid tightly, frown, or smile on the affected
side. Her exam is otherwise unremarkable. This presentation likely represents paralysis
of CN:
a. III
b. IV
c.VII
d. VIII
b. Lyme disease antibody titer - You examine a 29 y/o female who has a sudden onset
of rt-sided facial asymmetry. She is unable to close her rt eyelid tightly, frown, or smile
on the affected side. Her exam is otherwise unremarkable. Which represents the most
appropriate diagnostic test for this patient?
a. complete blood cell count with WBC differential
b. Lyme disease antibody titer
c. computed tomography (CT) scan of the head with contrast medium
d. blood urea nitrogen and creatinine levels
b. should be initiated as soon as possible after the onset of facial paralysis - In
prescribing Prednisone for a pt with Bell's palsy, the NP considers that its use:
a. has not been shown to be helpful in improving outcomes in this condition
b. should be initiated as soon as possible after the onset of facial paralysis
c. is likely to help minimize ocular sxs
d. may prolong the course of the disease
c. cluster headache - A 40 y/o male presents with a 5 wk hx of recurrent headaches that
awaken him during the night. The pain is severe, lasts about 1 hr, and is located behind
his left eye. Additional sxs include lacrimation and nasal discharge. His PE is WNL. This
clinical presentation is most consistent with:
a. migraine without aura
b. migraine with aura
c. cluster headache
,d. increased intracranial pressure
c. migraine with aura - A 22 y/o female presents with a 3 yr hx of recurrent, unilateral,
pulsating headaches with vomiting and photophobia. The headaches, which generally
last 3 hrs, can be aborted by resting in a dark room. She can usually tell that she is
going to get a headache. She explains, "I see little squiggles before my eyes for about
15 min". This presentation is most consistent with:
a. tension-type headache
b. migraine without aura
c. migraine with aura
d. cluster headache
a. headaches that occur periodically in clusters - Indicators that a headache can be the
presenting sx of a serious illness and may require neuroimaging include all of the
following EXCEPT:
a. headaches that occur periodically in clusters
b. increasing frequency and severity of headaches
c. headache causing confusion, dizziness, and/or lack of coordination
d. headache causing awakening from sleep
a. amitriptyline - Prophylactic tx for migraine headaches includes the use of:
a. amitriptyline
b. ergot derivative
c. naproxen sodium
d. clonidine
a. acebutolol - Among the following beta blockers, which is the least effective in
preventing migraine headaches?
a. acebutolol
b. metoprolol
c. atenolol
d. propranolol
c. lamotrigine - Antiepileptic drugs useful for preventing migraine headaches include all
of the following EXCEPT:
a. divalproex
b. valproate
c. lamotrigine
,d. topiramate
d. ginkgo biloba - Evidence supports the use of all of the following vitamins and
supplements for migraine prevention EXCEPT:
a. butterbur
b. riboflavin
c. feverfew
d. ginkgo biloba
c. timolol - You are examining a 65 y/o male who has a hx of acute coronary syndrome
and migraine. Which of the following agents represents the best choice of acute
headache (abortive) therapy for this pt?
a. verapamil
b. ergotamine
c. timolol
d. sumatriptan
c. oral naproxen sodium - A 45 y/o male experiences rapidly progressing migraine
headaches that are accompanied by significant GI upset. Appropriate acute headache
(abortive) tx includes all of the following EXCEPT:
a. injectable sumatriptan
b. dihydroergotamine nasal spray
c. oral naproxen sodium
d. zolmitriptan nasal spray
d. the pain is typically described as pulsating - With migraine, which of the following
statements is true?
a. migraine with aura is the most common form
b. most migraineurs are in ongoing healthcare for the condition
c. the condition is equally common in men and women
d. the pain is typically described as pulsating
a. over 65 years of age - Risk factors for cluster headaches include all of the following
EXCEPT:
a. over 65 years of age
b. heavy alcohol use
c. heavy tobacco use
d. male gender
, b. the pain is typically described as "pressing" in quality - In tension-type headaches,
which of the following is true?
a. photophobia is seldom reported
b. the pain is typically described as "pressing" in quality
c. the headache is usually unilateral
d. physical activity usually makes the discomfort worse
d. all of the above therapies - Tx options in cluster headache include the use of:
a. nonsteroidal anti-inflammatory drugs (NSAIDs)
b. O2
c. the triptans
d. all of the above therapies
b. liquid ibuprofen (Motrin, Advil) - Which of the following oral agents has the most rapid
analgesic onset?
a. naproxen (Naprosyn)
b. liquid ibuprofen (Motrin, Advil)
c. diclofenac (Voltaren)
d. enteric-coated naproxen (Naproxen EC)
c. high rate of rebound headache if used frequently - Limitations of use of butalbital with
acetaminophen and caffeine (Fioricet) include its:
a. energizing effect
b. gastrointestinal upset profile
c. high rate of rebound headache if used frequently
d. excessive cost
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