NMS Q&A Family Medicine

Pain and Headache Management 27(D) A photosensitive macular rash over the facialcheeks(E) Fever15 A 30-year-old woman complains of headaches thathave often occurred during her menstrual periods.Recently, she has begun hearing her own pulsation inher right ear. She weighs 120 lb (54.4 kg) and is 5 ft, 4in. (1.63 m) tall; she has no blood pressure or lipidabnormalities. You place your stethoscope over heroptic orbits and hear no abnormal sounds. When youmove the scope to the mastoid areas, you hear on theright a bruit timed with her peripheral pulse. What isthe most likely explanation of these findings?(A) Atherosclerotic stenosis of the right externalcarotid artery(B) Arteriovenous malformation(C) Migraine headache(D) Cluster headache(E) Temporal arteritis16 A 28-year-old woman complains of a 10-year historyof headaches. These headaches are fronto-occipital inlocation and are noted often at the end of workdays;they are more likely when sleep has been poor orshort and they are generally relieved by sleep. Theyhave always been quickly relieved by the use ofNSAIDs. She does note an increase in her headacheswhen she is under stress or anticipates stress. Whichof the following characteristics is most commonlyassociated with this type of headache?(A) There is an aura about 30 minutes before onsetof the headache.(B) There is nausea and emesis.(C) There is a gradual, often not precisely noticed,start and end to the headaches.(D) They are more common in men.(E) They are frequently brought on by oralcontraceptive usage.17 A 45-year-old man began 2 weeks ago to have headacheson a daily basis. They last 1 to 2 hours and areassociated with erythema of the face and rhinorrhea.The man says that he had a string of similar headachesabout a year ago. He suffered a concussion2 years ago and had headaches for several monthsafterward, but he has had none since until the recurrentheadaches a year ago. Which of the followingdoes this patient have?(A) Allergic rhinitis(B) Classic migraine(C) Cluster headache(D) Tension, vascular headache(E) Post-traumatic headache