Headache quiz – The Emergency Medicine Manual

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Created on July 13, 2025 By Bob Dunn

Headache quiz

This is a 10 question quiz of single best choice MCQs with 4 options.
The questions are randomly selected from a bank of 50 questions so will be different each time the quiz is taken.
Questions are of an ACEM Fellowship exam degree of difficulty.

1 / 10

1. The specificity of CSF xanthochromia measured by spectrophotometry for the diagnosis of SAH is approximately

a) 90%

b) 95%

c) 85%

d) 100%

The specificity of CSF xanthochromia measured by spectrophotometry for the diagnosis of SAH is approximately 85%. True positives usually also have at least 100 RBCs/mL.

The specificity of CSF xanthochromia measured by spectrophotometry for the diagnosis of SAH is approximately 85%. True positives usually also have at least 100 RBCs/mL.

2 / 10

2. Which one of the following blood pressure lowering agents should be avoided in the treatment of posterior reversible encephalopathy syndrome.

a) Labetalol

b) GTN

c) Metoprolol

d) Hydralazine

The blood pressure lowering agent that should be avoided in the treatment of posterior reversible encephalopathy syndrome is GTN. Apart from being associated with worse outcomes, it also potentiates headache so is best avoided in all patients with headache who require BP control.

The blood pressure lowering agent that should be avoided in the treatment of posterior reversible encephalopathy syndrome is GTN. Apart from being associated with worse outcomes, it also potentiates headache so is best avoided in all patients with headache who require BP control.

3 / 10

3. The risk of which one of the following is not increased by pregnancy

a) Pre-eclampsia

b) Pituitary apoplexy

c) Cerebral venous sinus thrombosis

d) Worsening of existing migraine

The risk of worsening migraines is not increased by pregnancy, it is usually decreased. However some women develop migraine for the first time during pregnancy.

The risk of worsening migraines is not increased by pregnancy, it is usually decreased. However some women develop migraine for the first time during pregnancy.

4 / 10

4. The earliest a headache has reported to have resolved following a SAH following presentation is

a) 24 hours

b) 6 hours

c) 2 hours

d) 10 hours

The earliest a headache has reported to have resolved following a SAH following presentation is 10 hours.

The earliest a headache has reported to have resolved following a SAH following presentation is 10 hours.

5 / 10

5. The sensitivity of a plain CT brain for detecting features of a cerebral venous sinus thrombosis is approximately

a) 80%

b) 40%

c) 20%

d) 60%

The sensitivity of a plain CT brain for detecting features of a cerebral venous sinus thrombosis is approximately 80% overall, especially for larger sinus thrombosis most likely to cause presentation to an ED. A thrombus may be seen directly or is suggestive if the contents of a sinus are greater than 60 Hounsfield units. Bilateral cortical oedema is also suggestive.

The sensitivity of a plain CT brain for detecting features of a cerebral venous sinus thrombosis is approximately 80% overall, especially for larger sinus thrombosis most likely to cause presentation to an ED. A thrombus may be seen directly or is suggestive if the contents of a sinus are greater than 60 Hounsfield units. Bilateral cortical oedema is also suggestive.

6 / 10

6. Apart from hypertension, the most frequent feature of posterior reversible encephalopathy syndrome (PRES) is

a) Headache

b) Seizures

c) Visual disturbance

d) Facial asymmetry

Other than hypertension (in 85%), seizures are the most common feature of PRES and occur in about 75% of cases. The seizures can be focal and status epilepticus occurs in about 20% of cases. Headache occurs in about 50% of cases and visual disturbances in 40%. Unilateral focal neurological deficits are rare.

Other than hypertension (in 85%), seizures are the most common feature of PRES and occur in about 75% of cases. The seizures can be focal and status epilepticus occurs in about 20% of cases. Headache occurs in about 50% of cases and visual disturbances in 40%. Unilateral focal neurological deficits are rare.

7 / 10

7. The sensitivity of a modern plain CT brain for the detection of SAH within 24 hours of symptom onset is approximately

a) 95%

b) 80%

c) 40%

d) 60%

The sensitivity of a modern plain CT brain for the detection of SAH within 24 hours of symptom onset is approximately 95%. Previous suggestions that the sensitivity of CT drops significantly starting at 6 hours after symptom onset relate to now outdated CT technology, improvements in reporting and the way previous study results were reported.

The sensitivity of a modern plain CT brain for the detection of SAH within 24 hours of symptom onset is approximately 95%. Previous suggestions that the sensitivity of CT drops significantly starting at 6 hours after symptom onset relate to now outdated CT technology, improvements in reporting and the way previous study results were reported.

8 / 10

8. The sensitivity of modern CT scanners for posterior reversible encephalopathy syndrome (PRES) is approximately

a) 50%

b) 80%

c) 10%

d) 20%

The sensitivity of modern CT scanners for posterior reversible encephalopathy syndrome (PRES) is approximately 80%. Commonly cited sensitivities as low as 20% are from studies using CT technology more than 20 years old when awareness of the features of PRES was much less.

The sensitivity of modern CT scanners for posterior reversible encephalopathy syndrome (PRES) is approximately 80%. Commonly cited sensitivities as low as 20% are from studies using CT technology more than 20 years old when awareness of the features of PRES was much less.

9 / 10

9. The range of opening CSF pressures on LP in a supine adult considered as normal is

a) 12-25 cmH2O

b) 5-15 cm H2O

c) 7-18 cmH2O

d) 7-18 mm H2O

The range of opening CSF pressures on LP in a supine adult considered as normal is 7-18 cm H20, although pressures as high as 25 cm H20 can be normal.

The range of opening CSF pressures on LP in a supine adult considered as normal is 7-18 cm H20, although pressures as high as 25 cm H20 can be normal.

10 / 10

10. The most common location of neuroimaging findings in PRES is

a) Cerebellar vermis and cortex

b) Superior frontal gyrus

c) Parietal and occipital lobes

d) Brainstem or spinal cord

The most common location of neuroimaging findings in PRES is in the parietal and occipital lobes which occurs in 75% of cases. A superior frontal sulcus pattern is seen in 25% of case, and other locations are rare (<5%).

The most common location of neuroimaging findings in PRES is in the parietal and occipital lobes which occurs in 75% of cases. A superior frontal sulcus pattern is seen in 25% of case, and other locations are rare (<5%).

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