H & P Lecture #4
H & P lecture #4, covers exam abnormalities. . . I also got a lot of information from Bates, I don't know how much detail we need to know out of Bates, but its better to be safe than sorry! :)
- 1.A ____________ headache is not associated with any underlying pathology, and is the most common type of headache. A _____________ headache can be attributed to an underlying pathologic condition, but are a much rarer form of headaches.
- A.
Secondary, primary
- B.
Primary, secondary
- C.
Migraine, cluster
- D.
Tension, cluster
- E.
Primary, cluster
- 2.You have a patient who comes in complaining of a headache for the past 48 hours. He went out drinking recently, and he thinks this might be what provoked his headache. He thought it was just a hangover, but then it got progressively worse, and is throbbing and achy. He describes sensory and motor auras, phonophobia, photophobia, nausea, and vomiting. He says he is the most comfortable laying down in his bedroom, with the lights off. What is your diagnosis?
- A.
Cluster headache
- B.
Tension headache
- C.
Migraine headache
- D.
Acute glaucoma
- E.
Subarachnoid hemorrhage
- 3.Your patient Dorota comes in, complaining of a headache that is very tight and pressing frontally. It has been gradually getting worse since yesterday. She explains that she was up all night typing quizzes while studying for midterms. She has had some slight photophobia, and the only thing that seems to make it feel better is when her wonderful husband Aaron massages her head while she relaxes in between midterms. What is your diagnosis?
- A.
Cluster headache
- B.
Tension headache
- C.
Migraine headache
- D.
Acute glaucoma
- E.
Subarachnoid hemorrhage
- 4.Which of the following types of headaches is associated with unilateral lacrimation, rhinorrhea, miosis, ptosis, eyelid edema, conjunctival injection, and arises episodically for hours at a time, but then goes into remission for weeks or months? (**Hint: this type of headache tends to be provoked by alcohol, and there doesn't seem to be anything that makes it feel better!)
- A.
Cluster headache
- B.
Tension headache
- C.
Migraine headache
- D.
Acute glaucoma
- E.
Subarachnoid hemorrhage
- 5.Which of the following is not considered a "secondary" headache?
- A.
Migraine headache
- B.
Acute glaucoma
- C.
Subarachnoid hemorrhage
- D.
Sinusitis
- E.
Temporal arteritis
- 6.Your patient comes in, complaining of a sandy sensation in their eye, with a steady, aching, severe pain. He explains that he was meticulously building a model ship-in-a-bottle all weekend, and ever sense, he has had deep pain around his eye. You notice conjunctival redness, and ciliary injection. What is your diagnosis?
- A.
Chronic glaucoma
- B.
Keratoconjunctivitis Sicca
- C.
Acute glaucoma
- D.
Conjunctivitis
- E.
Acanthamoeba keratitis
- 7.Amanda comes in complaining of nasal congestion and discharge, fever, and facial pain above her cheek. She says it has been aching and throbbing for two days, and hurts worse when she coughs or sneezes. You decide to prescribe her a decongestant and antibiotic, what diagnosis are you treating?
- A.
Cluster headache
- B.
Tension headache
- C.
Migraine headacha
- D.
Sinusitis headache
- E.
Strep type A infection of the sinuses
- 8.Which of the following is usually described as the "worst headache of my life," is associated with nausea, vomiting, loss of consciousness, and neck pain?
- A.
Cluster headache
- B.
Tension headache
- C.
Migraine headache
- D.
Temporal arteritis
- E.
Subarachnoid hemorrhage
- 9.You have a patient who comes in complaining of a headache along with scalp tenderness, fever, fatigue, jaw claudication, polymyalgia rheumatica, visual loss, and blindess. The onset was rapid, he is experiencing severe throbbing, pain with movement of his neck and shoulders, and nothing seems to make it better! What is your diagnosis?
- A.
Cluster headache
- B.
Tension headache
- C.
Migraine headache
- D.
Subarachnoid hemorrhage
- E.
Temporal arteritis
- 10.Which of the following dizziness symptoms is described as a spinning sensation along with nystagmus and ataxia?
- A.
Vertigo
- B.
Presyncope
- C.
Dysequilibrium
- D.
Psychiatric dizziness
- E.
Multifactorial
- 11.Which of the following dizziness symptoms is described as the feeling of being faint or lightheaded?
- A.
Vertigo
- B.
Presyncope
- C.
Dysequilibrium
- D.
Psychiatric dizziness
- E.
Multifactorial
- 12.Which of the following symptoms of dizziness is described as imbalance when walking?
- A.
Vertigo
- B.
Presyncope
- C.
Dysequilibrium
- D.
Psychiatric dizziness
- E.
Multifactorial
- 13.Which of the following dizziness symptoms is described as being associated with anxiety, panic disorder, and depression?
- A.
Vertigo
- B.
Presyncope
- C.
Dysequilibrium
- D.
Psychiatric dizziness
- E.
Multifactorial
- 14.Which of the following correctly describes the peripheral vertigo called benign positional vertigo?
- A.
Suddent dizziness due to a central brainstem lesion such as atherosclerosis.
- B.
Sudden onset of dizziness lasting hours to weeks with nausea, vomiting, and nystagmus.
- C.
Sudden onset of dizziness when moving head; accompanied by nystagmus and may or may not have nausea and vomiting.
- D.
Sudden dizziness typically associated with other neurological deficits.
- E.
Sudden dizziness typically associated with recent upper respiratory infection.
- 15.Which of the following correctly describes the peripheral vertigo called acute labyrinthitis? (**Hint, two correct answers)
- A.
Suddent dizziness due to a central brainstem lesion such as atherosclerosis.
- B.
Sudden onset of dizziness lasting hours to weeks with nausea, vomiting, and nystagmus.
- C.
Sudden onset of dizziness when moving head; accompanied by nystagmus and may or may not have nausea and vomiting.
- D.
Sudden dizziness typically associated with other neurological deficits.
- E.
Sudden dizziness typically associated with recent upper respiratory infection.
- 16.Which of the following correctly describes central vertigo?
- A.
Suddent dizziness due to a central brainstem lesion such as atherosclerosis.
- B.
Sudden onset of dizziness lasting hours to weeks with nausea, vomiting, and nystagmus.
- C.
Sudden onset of dizziness when moving head; accompanied by nystagmus and may or may not have nausea and vomiting.
- D.
Sudden dizziness typically associated with other neurological deficits.
- E.
Sudden dizziness typically associated with recent upper respiratory infection.
- 17.Closed-angle and Acute-angle closure glaucoma are two names for the same condition. What is another name for this same condition?
- A.
Open-angle glaucoma
- B.
Open-closure glaucoma
- C.
Narrow-angle glaucoma
- D.
Narrow-closure glaucoma
- 18.Which of the following "red-eye" conditions is classified by eye pain, headaches, halos around lights, dilated pupils, vision loss, nausea, vomiting, and ciliary injection?
- A.
Conjunctivitis
- B.
Subconjunctival Hemorrhage
- C.
Narrow-angle glaucoma
- D.
Acute iritis
- E.
Open-angle glaucoma
- 19.Which of the following is a condition that often has no symptoms, no shadow when testing the depth of the anterior shadow, but increased IOP leads to damage to the optic nerve and vision loss over time? (**Hint, this condition is not a common cause of red eye)
- A.
Acute iritis
- B.
Open-angle glaucoma
- C.
Conjunctivits
- D.
Subconjunctival Hemorrhage
- E.
Narrow-angle glaucoma
- 20.Which of the following eye conditions is described as a pattern of red peripheral conjunctival injection, usually caused by bacterial or viral infection, that causes mild discomfort but no pain, and has ocular discharge present?
- A.
Subconjunctival hemorrhage
- B.
Acute uveitis
- C.
Acute iritis
- D.
Narrow-angle glaucoma
- E.
Conjunctivitis
- 21.Which of the following red eye conditions looks much worse than it really is, and is commonly caused by trauma, bleeding disorders, or a sudden increase in venous pressure (cough, vomit).
- A.
Narrow-angle glaucoma
- B.
Acute iritis
- C.
Conjunctivitis
- D.
Subconjunctival hemorrhage
- E.
Pterygium
- 22.Which of the following benign conditions is associated with normal aging (but can be seen in young people sometimes), is a grayish-white arc near the edge of the cornea, and can suggest hyperlipidemia? (**Hint--there are THREE correct answers!)
- A.
Pterygium
- B.
Corneal arcus
- C.
Cataracts
- D.
Senile arcus
- E.
Arcus senilis
- 23.Which of the following describes the condition of anisocoria?
- A.
One pupil is larger, regular, and has a slowed or absent reaction to light. Slow accommodation causes blurred vision and DTRs are often decreased.
- B.
The dilated pupil is fixed to light and near effort. Ptosis of the upper eyelid and lateral deviation is almost always present.
- C.
The affected pupil, although small, reacts briskly to light and near effort. Ptosis of the eyelid, with loss of sweating on the forehead, and the affected iris is lighter than the normal eye.
- D.
Greater in bright light, the larger pupil cannot constrict properly because of an impaired PNS, and in dim light, the smaller pupil cannot dilate properly because of an impaired SNS
- E.
Small, irregular pupils that accommodate but do not react to light.
- 24.Which of the following describes the condition of Adie's (tonic) pupil?
- A.
One pupil is larger, regular, and has a slowed or absent reaction to light. Slow accommodation causes blurred vision and DTRs are often decreased.
- B.
Small, irregular pupils that accommodate but do not react to light.
- C.
Greater in bright light, the larger pupil cannot constrict properly because of an impaired PNS, and in dim light, the smaller pupil cannot dilate properly because of an impaired SNS
- D.
The dilated pupil is fixed to light and near effort. Ptosis of the upper eyelid and lateral deviation is almost always present.
- E.
The affected pupil, although small, reacts briskly to light and near effort. Ptosis of the eyelid, with loss of sweating on the forehead, and the affected iris is lighter than the normal eye.
- 25.Which of the following describes the condition of Oculomotor nerve paralysis?
- A.
The affected pupil, although small, reacts briskly to light and near effort. Ptosis of the eyelid, with loss of sweating on the forehead, and the affected iris is lighter than the normal eye.
- B.
Greater in bright light, the larger pupil cannot constrict properly because of an impaired PNS, and in dim light, the smaller pupil cannot dilate properly because of an impaired SNS
- C.
Small, irregular pupils that accommodate but do not react to light.
- D.
One pupil is larger, regular, and has a slowed or absent reaction to light. Slow accommodation causes blurred vision and DTRs are often decreased.
- E.
The dilated pupil is fixed to light and near effort. Ptosis of the upper eyelid and lateral deviation is almost always present.
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