HIGHLIGHTS OF NEURO, MUSKULOSKELETAL, & MENTAL
HEALTH-NM703 EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED
Tension headaches:
-Squeezing band-like pain
-mild-moderate pain
-no associated nausea/vomiting or phono-phobia
-may have photo-phobia
-can last 30 minutes to hours
-usually managed well with OTC medications*
Cluster headaches:
-severe pain that usually wakes them up in the middle of the night
-unilateral pain, usually retro-orbital
-unable to sit still
-can last 15 minutes-hours
-increased risk of self-harm and suicide*
Migraine:
-can last hours to days
-associated nausea/vomiting, light sensitivity, sound sensitivity
-may have AURA (visual disturbances or somatosensory can precede headache)
-usually associated with triggers
What are things that may help prevent or decrease migraine occurrences?
,-avoiding individualized triggers
-relaxation techniques
-acupressure
-regular exercise
-adequate sleep
-good nutrition
What is something to consider if a patient presents with daily headaches but also
utilize OTC medications frequently for them?
-Rebound headaches
What is the first line abortive treatment for mild-moderate headaches?
-NSAID analgesics
What is a good go-to medication to help increase the effectiveness of an abortive
medication for a migraine?
-Reglan (helps increase gastric motility which is usually turned off during a migraine--
this will help increase absorption of abortive medication)
What classes are good for abortive treatment of headaches that are moderate-
severe?
-triptans & ergots (vasoconstrictors)
-do not use in pregnancy*
-caution in those with HTN
When would a preventative medication be indicated for headache management?
What medications are available as prevention?
, -headaches occur >4X month
-severe
-do not respond well to abortive medications
-Beta blockers*, Ca channel blockers, anticonvulsants, TCAs, SSRIs
What are red flags and indications for referrals with headaches?
-new onset of headache as "worst headache of my life"
-new onset headache in someone >50
-associated with any neurologic symptoms
What is vertigo?
-sensation of spinning or that the environment is spinning around them
-peripheral* or central causes
Types of peripheral vertigo?
-BPPV
-Menieres disease
-Vestibular neuronitis
BPPV (benign paroxysmal positional vertigo):
-most common type--especially in elderly
-free floating crystal particles move around the semicircular canal with head movements
-abrupt position changes usually triggers it
-usually resolves on own
-refer to vestibular physical therapy to shorten recovery time*
-teach Epleys maneuver to do at home as will often reoccur*
-Meclizine can be used but usually isn't as effective
HEALTH-NM703 EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED
Tension headaches:
-Squeezing band-like pain
-mild-moderate pain
-no associated nausea/vomiting or phono-phobia
-may have photo-phobia
-can last 30 minutes to hours
-usually managed well with OTC medications*
Cluster headaches:
-severe pain that usually wakes them up in the middle of the night
-unilateral pain, usually retro-orbital
-unable to sit still
-can last 15 minutes-hours
-increased risk of self-harm and suicide*
Migraine:
-can last hours to days
-associated nausea/vomiting, light sensitivity, sound sensitivity
-may have AURA (visual disturbances or somatosensory can precede headache)
-usually associated with triggers
What are things that may help prevent or decrease migraine occurrences?
,-avoiding individualized triggers
-relaxation techniques
-acupressure
-regular exercise
-adequate sleep
-good nutrition
What is something to consider if a patient presents with daily headaches but also
utilize OTC medications frequently for them?
-Rebound headaches
What is the first line abortive treatment for mild-moderate headaches?
-NSAID analgesics
What is a good go-to medication to help increase the effectiveness of an abortive
medication for a migraine?
-Reglan (helps increase gastric motility which is usually turned off during a migraine--
this will help increase absorption of abortive medication)
What classes are good for abortive treatment of headaches that are moderate-
severe?
-triptans & ergots (vasoconstrictors)
-do not use in pregnancy*
-caution in those with HTN
When would a preventative medication be indicated for headache management?
What medications are available as prevention?
, -headaches occur >4X month
-severe
-do not respond well to abortive medications
-Beta blockers*, Ca channel blockers, anticonvulsants, TCAs, SSRIs
What are red flags and indications for referrals with headaches?
-new onset of headache as "worst headache of my life"
-new onset headache in someone >50
-associated with any neurologic symptoms
What is vertigo?
-sensation of spinning or that the environment is spinning around them
-peripheral* or central causes
Types of peripheral vertigo?
-BPPV
-Menieres disease
-Vestibular neuronitis
BPPV (benign paroxysmal positional vertigo):
-most common type--especially in elderly
-free floating crystal particles move around the semicircular canal with head movements
-abrupt position changes usually triggers it
-usually resolves on own
-refer to vestibular physical therapy to shorten recovery time*
-teach Epleys maneuver to do at home as will often reoccur*
-Meclizine can be used but usually isn't as effective
