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NEUROLOGICAL EXAMINATION: HEADACHE
Based on Bebe Babbitt Case Study
iHuman NR509 – Clinical Learning Objectives
.
Total Questions: 150 | Type: Multiple Choice
Answers + Explanations immediately after each question
.
SECTION 1: HEADACHE HISTORY & SUBJECTIVE DATA COLLECTION (Q1–30)
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1. When assessing a patient with headache, which is the best open-ended initial question?
A) "Do you have a migraine?"
B) "Tell me about your headache from the beginning."
C) "Rate your pain 0-10."
D) "Did you take any medication?"
Answer: B – Open-ended question allows patient to describe the full history.
2. A patient describes "the worst headache of my life" that came on suddenly within seconds. This
suggests:
A) Migraine
B) Tension headache
C) Subarachnoid hemorrhage
D) Cluster headache
Answer: C – "Thunderclap headache" is a red flag for subarachnoid hemorrhage.
3. Which question best assesses migraine-associated symptoms?
A) "Do you have nausea, vomiting, or sensitivity to light/sound?"
,B) "Do you have fever?"
C) "Do you have joint pain?"
D) "Do you have chest pain?"
Answer: A – Nausea, photophobia, phonophobia are classic migraine features.
4. Bebe Babbitt reports headaches that occur 3-4 times per month. This frequency is classified as:
A) Episodic migraine
B) Chronic migraine
C) Daily persistent headache
D) Cluster period
Answer: A – Episodic migraine = <15 headache days per month; chronic = ≥15.
5. Which question screens for visual aura?
A) "Do you see flashing lights, zigzag lines, or blind spots before the headache?"
B) "Do you have double vision all the time?"
C) "Is your vision blurry?"
D) "Do you need glasses?"
Answer: A – Visual aura is transient and precedes migraine in 25-30% of patients.
6. A patient reports headache that worsens with coughing, sneezing, or Valsalva maneuver. This
suggests:
A) Benign tension headache
B) Increased intracranial pressure or structural lesion
C) Migraine
D) Sinus headache
Answer: B – Headache exacerbated by Valsalva is a red flag for mass lesion or elevated ICP.
7. Which medication overuse can cause rebound headache?
A) Acetaminophen (less than 2 days/week)
,B) Triptans (≥10 days/month)
C) Ibuprofen (once per month)
D) Naproxen (once per week)
Answer: B – Medication overuse headache occurs with triptans ≥10 days/month or simple analgesics
≥15 days/month.
8. When asking about family history, which finding is most relevant?
A) Diabetes
B) Hypertension
C) Migraine in first-degree relative
D) Asthma
Answer: C – Migraine has strong genetic component; positive family history supports diagnosis.
9. A 35-year-old woman reports headache with new-onset neurologic deficit (arm weakness). What
should you do?
A) Diagnose migraine with aura
B) Order urgent neuroimaging (CT or MRI)
C) Prescribe triptans
D) Send home with rest
Answer: B – New focal neurologic deficit with headache requires urgent imaging to rule out stroke or
mass.
10. Which question identifies possible giant cell arteritis in a patient over 50?
A) "Do you have jaw claudication or scalp tenderness?"
B) "Do you have ringing in your ears?"
C) "Do you have dizziness?"
D) "Do you have palpitations?"
Answer: A – Jaw pain with chewing (claudication) and tender scalp are classic for giant cell arteritis.
, 11. A patient describes periorbital stabbing pain occurring at the same time each night for 2 weeks. This
suggests:
A) Migraine
B) Tension headache
C) Cluster headache
D) Medication overuse headache
Answer: C – Cluster headaches are strictly unilateral, periorbital, occur in clusters, often at same time
nightly.
12. Which question screens for meningitis?
A) "Do you have stiff neck and fever?"
B) "Do you have back pain?"
C) "Do you have knee pain?"
D) "Do you have rash on arms only?"
Answer: A – Nuchal rigidity + fever + headache suggests meningitis.
13. A patient reports headache that is worse in the morning and improves during the day. This suggests:
A) Migraine
B) Increased intracranial pressure (ICP)
C) Tension headache
D) Sinus headache
Answer: B – Headache worse upon waking is classic for elevated ICP (pressure builds overnight when
supine).
14. Which dietary trigger is commonly associated with migraine?
A) Fresh fruit
B) Aged cheese (tyramine)
C) Boiled vegetables
D) White rice
NEUROLOGICAL EXAMINATION: HEADACHE
Based on Bebe Babbitt Case Study
iHuman NR509 – Clinical Learning Objectives
.
Total Questions: 150 | Type: Multiple Choice
Answers + Explanations immediately after each question
.
SECTION 1: HEADACHE HISTORY & SUBJECTIVE DATA COLLECTION (Q1–30)
.
1. When assessing a patient with headache, which is the best open-ended initial question?
A) "Do you have a migraine?"
B) "Tell me about your headache from the beginning."
C) "Rate your pain 0-10."
D) "Did you take any medication?"
Answer: B – Open-ended question allows patient to describe the full history.
2. A patient describes "the worst headache of my life" that came on suddenly within seconds. This
suggests:
A) Migraine
B) Tension headache
C) Subarachnoid hemorrhage
D) Cluster headache
Answer: C – "Thunderclap headache" is a red flag for subarachnoid hemorrhage.
3. Which question best assesses migraine-associated symptoms?
A) "Do you have nausea, vomiting, or sensitivity to light/sound?"
,B) "Do you have fever?"
C) "Do you have joint pain?"
D) "Do you have chest pain?"
Answer: A – Nausea, photophobia, phonophobia are classic migraine features.
4. Bebe Babbitt reports headaches that occur 3-4 times per month. This frequency is classified as:
A) Episodic migraine
B) Chronic migraine
C) Daily persistent headache
D) Cluster period
Answer: A – Episodic migraine = <15 headache days per month; chronic = ≥15.
5. Which question screens for visual aura?
A) "Do you see flashing lights, zigzag lines, or blind spots before the headache?"
B) "Do you have double vision all the time?"
C) "Is your vision blurry?"
D) "Do you need glasses?"
Answer: A – Visual aura is transient and precedes migraine in 25-30% of patients.
6. A patient reports headache that worsens with coughing, sneezing, or Valsalva maneuver. This
suggests:
A) Benign tension headache
B) Increased intracranial pressure or structural lesion
C) Migraine
D) Sinus headache
Answer: B – Headache exacerbated by Valsalva is a red flag for mass lesion or elevated ICP.
7. Which medication overuse can cause rebound headache?
A) Acetaminophen (less than 2 days/week)
,B) Triptans (≥10 days/month)
C) Ibuprofen (once per month)
D) Naproxen (once per week)
Answer: B – Medication overuse headache occurs with triptans ≥10 days/month or simple analgesics
≥15 days/month.
8. When asking about family history, which finding is most relevant?
A) Diabetes
B) Hypertension
C) Migraine in first-degree relative
D) Asthma
Answer: C – Migraine has strong genetic component; positive family history supports diagnosis.
9. A 35-year-old woman reports headache with new-onset neurologic deficit (arm weakness). What
should you do?
A) Diagnose migraine with aura
B) Order urgent neuroimaging (CT or MRI)
C) Prescribe triptans
D) Send home with rest
Answer: B – New focal neurologic deficit with headache requires urgent imaging to rule out stroke or
mass.
10. Which question identifies possible giant cell arteritis in a patient over 50?
A) "Do you have jaw claudication or scalp tenderness?"
B) "Do you have ringing in your ears?"
C) "Do you have dizziness?"
D) "Do you have palpitations?"
Answer: A – Jaw pain with chewing (claudication) and tender scalp are classic for giant cell arteritis.
, 11. A patient describes periorbital stabbing pain occurring at the same time each night for 2 weeks. This
suggests:
A) Migraine
B) Tension headache
C) Cluster headache
D) Medication overuse headache
Answer: C – Cluster headaches are strictly unilateral, periorbital, occur in clusters, often at same time
nightly.
12. Which question screens for meningitis?
A) "Do you have stiff neck and fever?"
B) "Do you have back pain?"
C) "Do you have knee pain?"
D) "Do you have rash on arms only?"
Answer: A – Nuchal rigidity + fever + headache suggests meningitis.
13. A patient reports headache that is worse in the morning and improves during the day. This suggests:
A) Migraine
B) Increased intracranial pressure (ICP)
C) Tension headache
D) Sinus headache
Answer: B – Headache worse upon waking is classic for elevated ICP (pressure builds overnight when
supine).
14. Which dietary trigger is commonly associated with migraine?
A) Fresh fruit
B) Aged cheese (tyramine)
C) Boiled vegetables
D) White rice
